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1.
BMJ Open ; 12(1): e047748, 2022 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-35017230

RESUMEN

OBJECTIVES: To explore clinically important increases in depression/anxiety from before to during the first UK COVID-19 lockdown and factors related to this change, with a particular focus on ethnic differences. DESIGN: Pre-COVID-19 and lockdown surveys nested within two longitudinal Born in Bradford cohort studies. PARTICIPANTS: 1860 mothers with a child aged 0-5 or 9-13, 48% Pakistani heritage. MAIN OUTCOME MEASURES: ORs for a clinically important increase (5 points or more) in depression (eight item Patient Health Questionnaire (PHQ-8)) and anxiety (Generalised Anxiety Disorder Assessment (GAD-7)) in unadjusted regression analyses, repeated with exposures of interest separated by ethnicity to look for differences in magnitude of associations, and lived experience of mothers captured in open text questions. RESULTS: The number of women reporting clinically important depression/anxiety increased from 11% to 20% (95% CI 10%-13%; 18%-22%) and from 10% to 16% (95% CI 8%-11%; 15%-18%), respectively. Increases in depression/anxiety were associated with loneliness (OR=8.37, 95% CI 5.70 to 12.27; 8.50, 95% CI 5.71 to 12.65, respectively); financial (6.23, 95% CI 3.96 to 9.80; 6.03, 95% CI 3.82 to 9.51), food (3.33, 95% CI 2.09 to 5.28; 3.46, 95% CI 2.15 to 5.58) and housing insecurity (3.29, 95% CI 2.36 to 4.58; 3.0, 95% CI 2.11 to 4.25); a lack of physical activity (3.13, 95% CI 2.15 to 4.56; 2.55, 95% CI 1.72 to 3.78); and a poor partner relationship (3.6, 95% CI 2.44 to 5.43; 5.1, 95% CI 3.37 to 7.62). The magnitude of associations between key exposures and worsening mental health varied between ethnic groups.Responses to open text questions illustrated a complex interplay of challenges contributing to mental ill health including: acute health anxieties; the mental load of managing multiple responsibilities; loss of social support and coping strategies; pressures of financial and employment insecurity; and being unable to switch off from the pandemic. CONCLUSIONS: Mental ill health has worsened for many during the COVID-19 lockdown, particularly in those who are lonely and economically insecure. The magnitude of associations between key exposures and worsening mental health varied between ethnic groups. Mental health problems may have longer term consequences for public health and interventions that address the potential causes are needed.


Asunto(s)
COVID-19 , Salud Mental , Ansiedad/epidemiología , Niño , Control de Enfermedades Transmisibles , Depresión/epidemiología , Femenino , Humanos , Estudios Longitudinales , Madres , SARS-CoV-2 , Reino Unido
2.
Int Breastfeed J ; 17(1): 6, 2022 01 10.
Artículo en Inglés | MEDLINE | ID: mdl-35012631

RESUMEN

BACKGROUND: Mothers of preterm infants face many challenges in breastfeeding, especially regarding lactation. This study aimed to investigate the lactation status and challenges in breastfeeding faced by preterm infants' mothers. METHODS: We approached 124 mothers who gave birth to preterm infants between 26 May and 31 October 2018 in a tertiary hospital in China. Lactation status and challenges in breastfeeding on day 7 postpartum, at discharge of infants, 2 weeks post-discharge, and 3 months of corrected age were collected using questionnaires. The area under the receiver operating characteristic (ROC) curve for expressed milk volume on day 7 postpartum for predicting expressed milk volume ≥ 300 mL/d at discharge was calculated. Logistic regression analyses were performed to identify factors associated with delayed lactogenesis II onset and continuation of breastfeeding at 3 months of corrected age. RESULTS: Seventy mothers were enrolled, and 51.4% had delayed lactogenesis II. Multivariate logistic regression analysis revealed that older maternal age (aOR = 1.19; 95% CI: 1.01, 1.40) and first live birth (aOR = 4.81; 95% CI 1.43, 16.18) were significant independent predictors of delayed lactogenesis II. Mothers with delayed lactogenesis II had significantly lower expressed milk volume (day 7 postpartum: 160.0 mL vs. 300.0 mL, U = 328.50, p = 0.001; at discharge: 425.0 mL vs. 612.5 mL, U = 372.00, p = 0.005), with a lower proportion of exclusive breastfeeding in their infants (at discharge: 33.3% vs. 69.8%, χ2 = 12.39, df = 1, p < 0.001; 3 months of corrected age: 17.8% vs. 52.8%, χ2 = 11.03, df = 1, p = 0.001). The ROC showed that expressed milk volume > 190 mL/d on day 7 postpartum significantly predicted expressed milk volume ≥ 300 mL/d at discharge. Insufficient human milk was the main reason for breastfeeding discontinuation at 3 months of corrected age. Twins were less likely to continue breastfeeding at 3 months of corrected age (aOR = 0.27; 95% CI 0.09, 0.86). In singleton infants, mother's own milk ≥50% of total milk uptake at 2 weeks post-discharge (aOR = 32.66; 95% CI 3.00, 355.25) was an independent predictor of continuous breastfeeding at 3 months of corrected age. Feeding complications in infants, poor breastfeeding technique, and low milk output are the main challenges in breastfeeding. CONCLUSION: Interventions to improve early postpartum lactation and breastfeeding techniques may increase breastfeeding adoption in mothers of preterm infants.


Asunto(s)
Lactancia Materna , Madres , Adolescente , Cuidados Posteriores , Femenino , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Lactancia , Alta del Paciente , Embarazo , Estudios Prospectivos
3.
BMJ Case Rep ; 15(1)2022 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-35027381

RESUMEN

A 35-year-old primigravida presented with significant anxiety symptoms at 26 weeks' gestation. Symptoms were preceded by a nightmare about her upcoming labour. She developed repetitive intrusive thoughts of being trapped emotionally and physically in her pregnancy. Her symptoms were suggestive of new-onset claustrophobia associated with pregnancy, which has not been previously reported on. Her symptoms ameliorated with a combination of cognitive-behavioural therapy and pharmacotherapy (sertraline and low dose quetiapine). The later stages of pregnancy were associated with minimal symptoms and the resolution of her subjective 'entrapment'. A subsequent pregnancy resulted in similar although less severe symptomatology. No postpartum anxiety symptoms were demonstrated on both occasions. Anxiety symptoms can adversely impact both the mother and fetus, and thus correct identification and management of pregnancy-related claustrophobia improved symptomatology and functioning and allowed for earlier detection and reduced symptomatology in a subsequent pregnancy.


Asunto(s)
Terapia Cognitivo-Conductual , Trastornos Fóbicos , Adulto , Femenino , Edad Gestacional , Humanos , Madres , Trastornos Fóbicos/etiología , Periodo Posparto , Embarazo
4.
Int J Qual Stud Health Well-being ; 17(1): 2018773, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35012434

RESUMEN

PURPOSE: The novel coronavirus disease (COVID-19) outbreak has exponentially spread across the globe and formed one of the greatest health threats in history. Pregnant women are vulnerable, and their vulnerability is amplified by the associated containment measures of the pandemic. In this study, we aim to explore and describe expectant mothers' experiences during the lockdown of COVID-19. METHOD: A qualitative descriptive design was used. Eighteen pregnant and postpartum women were recruited through purposive and snowball sampling. Semi-structured phone call interviews were conducted by a female researcher. Braun and Clarke's thematic data analysis was followed. RESULTS: Three main themes are developed: (1) Living with fears and uncertainties amid the COVID-19 pandemic, (2) Lockdown disrupting the normalcy of pregnancy, (3) Trying to control the chaos of life. Five subthemes underlined the three themes. CONCLUSION: Findings portrayed expectant mothers' uncertainties, fears, and the fragility of the healthcare systems in responding to mothers' needs during the COVID-19 pandemic. Although the pandemic has resulted in disruption of the normalcy of pregnancy, mothers sought adaptive means to protect themselves and maintain control. Governmental authorities and healthcare providers are directly responsible to maintain considerate perinatal care services for expectant mothers during lockdown and crises.


Asunto(s)
COVID-19 , Pandemias , Control de Enfermedades Transmisibles , Miedo , Femenino , Humanos , Madres , Embarazo , Investigación Cualitativa , SARS-CoV-2
5.
Reprod Health ; 19(1): 10, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-35033103

RESUMEN

BACKGROUND: Adolescent childbearing increases the risk of adverse health and social consequences including school dropout (SDO). However, it remains unclear why some teenage mothers drop out of school and others do not, especially in sub-Saharan Africa settings. We aimed to investigate the background and behavioral characteristics of single mothers, associated with school dropout in a sample of 18,791 Cameroonian girls, who had their first child during adolescence. METHODS: We used data from a national registry of single mothers, collected during the years 2005-2008 and 2010-2011. Both bivariate analysis and logistic binary regression models were used to explore the relationship between adolescence motherhood and SDO controlling for a range of socio-economic, family, sexual and health seeking behavior characteristics. RESULTS: Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. The multivariable regression model showed that SDO was more common in those who were evicted from their parental home (aOR: 1.85; 95% CI: 1.69-2.04), those who declared having other single mothers in their family (aOR: 1.16; 95% CI 1.08-1.25) and in mothers who had their first child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout. CONCLUSIONS: Strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.


There is compelling, worldwide evidence that pregnancy and birth during teenage years are significant contributors to high school dropout rates, especially in developing countries. Research has also shown that education continuity of teenage mothers can lessen the long term negative social consequences of teenage pregnancies and childbearing. In this study, we investigated the factors associated with school dropout in a sample of Cameroonian teenage mothers.The information collected included socio-economic, family, sexual characteristics, and health-seeking behavior.Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. School dropout was more common in those who were evicted from their parental home, those who declared having other single mothers in their family and in mothers who had their 1st child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout.In conclusion, strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Camerún , Niño , Femenino , Humanos , Madres , Embarazo , Abandono Escolar
6.
BMC Res Notes ; 15(1): 18, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-35033183

RESUMEN

OBJECTIVES: Limited studies were found to investigate the occupational performance of autistic children and their parents' quality of life. Therefore, this study aimed to investigate occupational performance of children with Autism Spectrum Disorder (ASD) and QoL of their mothers. RESULTS: In this study, 88 participants were selected from autism centers in Arak, Iran, 2020. The Canadian Occupational Performance Measure (COPM) and the parent version of Quality of Life in Autism Questionnaire (QoLA-P) were used to assess the occupational performance of ASD children and their mothers QoL. QoLA-P consists of parts A which is related to the quality of life and part-B related to the problems that these children have and are related to the parents or their caregivers. Regarding occupational performance, the first priority of mothers is self-care with frequency 64.8%. The finding suggested a significant correlation between total function score of COPM and the score of part-A (r = 0.227, p = 0.033) of QoLA-P. Also, the results revealed a significant correlation between the total satisfaction score of COPM and the score of part-A (r = 0.236, p = 0.026) and part-B of QoLA-P questionnaire (r = 0.231, p = 0.030). The mothers' first priority is self-care and, the total satisfaction and function score of COPM showed a significant correlation with mothers' QoL.


Asunto(s)
Trastorno del Espectro Autista , Calidad de Vida , Canadá , Niño , Femenino , Humanos , Madres , Encuestas y Cuestionarios
7.
Niger J Clin Pract ; 25(1): 62-68, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35046197

RESUMEN

Background: Every baby should start life with breastfeeding. However, some obstacles prevent babies from enjoying this right. Aim: This study aimed to determine the factors affecting breastfeeding within the first hour after birth. Patients and Methods: This study employed a comparison design. This was a comparative study of women who breastfeed their babies within 1 h of birth and those who did not. The research population consisted of 368 mothers who had babies aged 6-24 months. A semi-structured questionnaire, which consisted of 32 open- and closed-ended questions, was used to collect data. The number and proportions were used for the descriptive statistics, and Chi-square tests were used to compare data between groups. The level of statistical significance was accepted as P < 0.05. Results: Of the 368 participants, 50.8% breastfed their babies within the first hour after birth, 49.2% did not breastfeed within the first hour, 51.6% exclusively breastfed in the first 6 months, 48.4% did not breastfeed exclusively in the first 6 months. Moreover, results revealed that a high-risk pregnancy status, mode of delivery, prelacteal food, and the mother's role in making decisions about baby feeding affects breastfeeding practices within the first hour after birth. Conclusions: Initiatives should be increased to start breastfeeding within the first hour after birth in women who have high-risk pregnancy and those giving birth by cesarean section. Breast milk should be the baby's first food, and mothers should be the primary decision-makers in baby's nutrition.


Asunto(s)
Lactancia Materna , Cesárea , Femenino , Humanos , Lactante , Madres , Parto , Embarazo , Encuestas y Cuestionarios
8.
Niger J Clin Pract ; 25(1): 69-77, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35046198

RESUMEN

Background: The rate of cesarean section (CS) has been gradually increasing throughout the world. The impact of CS on the issue of breastfeeding success therefore merits attention. Aim: This study investigates postcesarean difficulties and their association with breastfeeding success. Patients and Methods: This study is a cross-sectional study involving the participation of 220 mothers who were receiving care at the Women's Health Training and Research Hospital in Ankara, Turkey between the dates of February 10 and August 10 of 2016. Data were collected using the Socio-demographic and Obstetric Characteristics Form and the LATCH Breastfeeding Assessment Tool (LBAT). Results: Women who had breastfeeding problems both previously (OR = 0.59; 95% CI: 0.18-1.76; P = 0.004) and currently (OR = 0.29; 95% CI: 0.14-1.30; P < 0.001) were more likely to have low breastfeeding success scores. There was no statistically significant relationship found between LBAT mean scores and other post-CS difficulties. Women aged 35 and older were more likely to have breastfeeding success compared to that of women of ≤19 years of age (OR = 4.33; 95% CI: 3.50-4.45; P = 0.051). Furthermore, women who had breastfeeding experience were more likely (OR = 1.86; 95% CI: 1.40-2.67; P = 0.010) to have a high breastfeeding success score. Conclusions: This study has revealed that breastfeeding success was associated more with breastfeeding problems than with other difficulties experienced after a CS. To prevent breastfeeding problems before they occur, newborns who are without complications should be kept in skin-to-skin contact (SSC) with their mothers immediately after the CS, breastfed within the first 1 hour after birth, and remain in SSC until the end of the first breastfeeding. Most importantly, to increase breastfeeding success after CS, creative staffing solutions need to be employed.


Asunto(s)
Lactancia Materna , Cesárea , Estudios Transversales , Femenino , Humanos , Recién Nacido , Madres , Periodo Posparto , Embarazo
9.
BMJ Case Rep ; 15(1)2022 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-34996767

RESUMEN

As an X linked disorder, the presence of severe symptomatic haemophilia A is an extremely rare disorder in women. Therefore there are no high-level evidence-based guidelines when it comes to pregnancy. Although there have been advances in the fields of prenatal counselling and maternal-fetal care, the management of these gestations continues to embody a challenge for any medical team. We report the successful management of a pregnant woman with symptomatic haemophilia A, from pregnancy to the postpartum period. Our aim is to enhance knowledge on this topic, and further improve outcomes for these mothers and their offspring.


Asunto(s)
Hemofilia A , Femenino , Hemofilia A/diagnóstico , Hemofilia A/terapia , Humanos , Madres , Periodo Posparto , Embarazo , Atención Prenatal
10.
Matern Child Health J ; 26(1): 15-23, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34978019

RESUMEN

BACKGROUND: In 2011, California enacted its public safety realignment initiative (realignment) motivated by a U.S. Supreme Court ruling to reduce state prison overcrowding and in effort to reduce recidivism. Realignment transferred authority for lower-level felony offenders from the state to the counties, leading to a rapid reduction in state prison incarceration levels. OBJECTIVE: This study drew on a unique dataset to assess the effects of California's efforts to downsize the prison system on maternal incarceration levels and to better understand the characteristics of incarcerated mothers and their children. METHODS: Incarceration records concerning all women in California state prisons between 2010 and 2012 (N = 16,917) were linked to 7.5 million vital birth records dating to 1999 to identify incarcerated women who had given birth. Multinomial logistic regression models were specified to better understand offense type differences among incarcerated mothers versus nonmothers. RESULTS: Findings indicate that realignment disproportionately affected women. The number of men entering prison decreased 67.8% between 2010 and 2012. In comparison, the number of women entering prison decreased 78.5%. Further, more than half of incarcerated women had given birth. Mothers were more likely than nonmothers to be convicted of nonviolent crimes. DISCUSSION: This study underscores how prison downsizing can disproportionately reduce incarceration levels for women. Given that such large proportion of incarcerated women were mothers, this policy change may have potential spillover next-generation benefits. Finally, this work reinforces the potential to use linked administrative records to study incarcerated populations.


Asunto(s)
Madres , Prisioneros , Certificado de Nacimiento , California , Niño , Femenino , Humanos , Masculino , Prisiones
11.
Environ Int ; 158: 106986, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34991248

RESUMEN

BACKGROUND/AIMS: Early life exposures to marine contaminants can adversely impact child health but modes of action are unclear. Human milk contains extracellular vesicles (EVs) that can transport biologically relevant cargo from mother to infant, including microRNAs (miRNAs), and may partly mediate the effects of pollutants on child health. However, the role of marine pollutants on miRNA expression in milk EVs is unexplored. METHODS: We isolated EV RNA from 333 milk samples collected between 2 and 74 days postpartum from a Faroese birth cohort born 1997-2000 and sequenced 2083 miRNAs using a targeted library preparation method. We quantified five perfluoroalkyl substances (PFAS), pesticide metabolite p,p'-dichlorodiphenyldichloroethylene (DDE), and the sum of three major polychlorinated biphenyls (ΣPCBs) in maternal serum at 34 weeks of gestation and maternal hair total mercury (Hg) at birth. We used negative binomial regressions to estimate associations between individual pollutants and 418 reliably expressed EV-miRNAs adjusted for potential confounders. We performed sparse principal components (PCs) analysis to derive the first four components of the EV-miRNA data and examined associations between pollutants and PCs using Bayesian kernel machine regression (BKMR). RESULTS: We observed no associations between pollutants and individual EV-miRNA expression after controlling the false discovery rate at 0.1. However, BKMR suggested that Hg was positively associated with PC1 and negatively associated with PC3, while ΣPCBs was negatively associated with PC3, and two PFAS were associated with PC4. Exploration of PC loadings followed by pathway analyses suggested that miRNAs in PC1 (miR-200b-3p, miR-664a-3p, miR-6738-5p, miR-429, miR-1236-5p, miR-4464, and miR-30b-5p) may be related to Hg neurotoxicity, while remaining PCs require further research. CONCLUSIONS: Our findings suggest that groups of milk EV-miRNAs may better serve as environmental biomarkers than individual miRNAs. Future studies are needed to elucidate the role of milk EV-miRNAs in child health following prenatal exposures.


Asunto(s)
Contaminantes Ambientales , Vesículas Extracelulares , MicroARNs , Teorema de Bayes , Niño , Contaminantes Ambientales/toxicidad , Femenino , Humanos , Recién Nacido , MicroARNs/genética , Leche Humana , Madres , Embarazo
13.
BMC Pregnancy Childbirth ; 22(1): 33, 2022 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-35030996

RESUMEN

BACKGROUND: COVID-19 vaccines are advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine uptake among pregnant women is inadequate. METHODS: An online survey and semi-structured interviews were used to investigate pregnant women's views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. One thousand one hundred eighty-one women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August-11th October 2020. Ten women were interviewed. RESULTS: The majority of women surveyed (81.2%) reported that they would 'definitely' or were 'leaning towards' accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p < 0.005) and for their babies (69.9%, p < 0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant, pregnant and for their babies compared to women from White ethnic groups (p < 0.005). Women from lower-income households, aged under 25-years, and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant, pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant, pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. CONCLUSION: Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19/prevención & control , Aceptación de la Atención de Salud/psicología , Complicaciones Infecciosas del Embarazo/prevención & control , Vacunación/psicología , Adulto , /estadística & datos numéricos , Femenino , Humanos , Renta , Madres/psicología , Embarazo , Mujeres Embarazadas/psicología , SARS-CoV-2/inmunología , Encuestas y Cuestionarios , Reino Unido/epidemiología
14.
Int Breastfeed J ; 17(1): 2, 2022 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980169

RESUMEN

BACKGROUND: The effects of breastfeeding practices on children's health are undoubtedly of great interest. However, inequalities in breastfeeding practices and mother and newborn skin-to-skin contact (SSC) exist in many resource-constrained settings. This study examined the regional prevalence and socioeconomic inequalities in exclusive breastfeeding (EBF), early initiation of breastfeeding and SSC in Nigeria. METHODS: Data on 2936 infants under six months were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS) to determine EBF. In addition, data on 21,569 children were analysed for early initiation of breastfeeding and SSC. Concentration index and curves were used to measure socioeconomic inequalities in EBF, early initiation of breastfeeding and SSC. RESULTS: The prevalence of EBF, early initiation of breastfeeding and SSC were 31.8, 44.2 and 12.1% respectively. Furthermore, Ogun state had the highest prevalence of EBF (71.4%); while Bayelsa state had the highest prevalence of SSC (67.8%) and early initiation of breastfeeding (96.2%) respectively. Urban dwellers had higher prevalence of EBF, SSC and early initiation of breastfeeding across household wealth quintile and by levels of mothers' education in contrast to their rural counterparts. We quantified inequalities in early initiation of breastfeeding, EBF, and SSC according to household wealth and maternal education. The study outcomes had greater coverage in higher household wealth, in contrast to the lower household wealth groups; early initiation of breastfeeding (concentration index = 0.103; p = 0.002), EBF (concentration index = 0.118; p < 0.001), and SSC (concentration index = 0.152; p < 0.001) respectively. Furthermore, early initiation of breastfeeding (concentration index = 0.091; p < 0.001), EBF (concentration index = 0.157; p < 0.001) and SSC (concentration index = 0.156; p < 0.001) had greater coverage among mothers with higher educational attainment. CONCLUSION: Low prevalence and socioeconomic inequalities in early initiation of breastfeeding, EBF and SSC were identified. We recommend that health promotion programs targeted and co-designed with disadvantaged mothers are critical to meet global breastfeeding targets. Also, future researchers should conduct further studies especially clinical control trials and qualitative studies to unravel the possible reasons for differences in the indicators.


Asunto(s)
Lactancia Materna , Madres , Niño , Femenino , Humanos , Lactante , Recién Nacido , Nigeria , Prevalencia , Factores Socioeconómicos
15.
Int Breastfeed J ; 17(1): 5, 2022 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-34983584

RESUMEN

BACKGROUND: Milk sharing is not a new concept and occurs today via regulated human milk banks and unregulated online milk sharing groups. Exploring and understanding how, and why, mothers use these peers to peer milk sharing groups, is a vehicle to understanding how breastfeeding mothers can be tangibly supported online, adding to the literature on peer milk sharing, from a recipient's perspective. This research presents a single case example of an online breastfeeding support group use, through one mother's experiencing of seeking human donor milk. METHOD: This is a qualitative, exploratory study observing the attitudes, thoughts, and feelings of one mother who is seeking human donor milk through online groups. A single key case was identified, and the participant was asked to document thoughts and feelings as she searched for milk online. A telephone interview was conducted after two months, and the online page activity from the Human Milk for Human Babies Facebook group was captured for the week following the interview. The results were presented in a chronological and linear analytical approach adopting pattern matching. RESULTS: 'Abbi' is a mother who has Polycystic Ovary Syndrome and subsequent low milk supply and sought donor breastmilk online. Online support groups introduced her to donor milk sharing, which not only supported her breastfeeding but supported her own mental health. Abbi talks of the need to build a trusting relationship with her donor, due to the lack of regulation, and the positive impact it had for her and 'Lucas', her baby. CONCLUSION: Considering milk sharing groups simply as tangible online support ignores the complexities around Abbi's decision to use human donor milk. Peer milk sharing online is an option for mothers, but it is surrounded by stigma amongst other mothers, professionals, and even within pro breastfeeding support groups.


Asunto(s)
Bancos de Leche , Leche Humana , Lactancia Materna , Femenino , Humanos , Lactante , Salud Mental , Madres
16.
Reprod Health ; 19(1): 5, 2022 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-35012569

RESUMEN

BACKGROUND: A Near Miss Mother (NMM) who survives life-threatening conditions, experiences intense physical, emotional, and psychological consequences following the maternal near-miss (MNM) events. The aim of this study was therefore to explore indepth understanding meaning of NMM everyday lived experiences on the social and cultural background of Iran. METHODS: This qualitative study utilized a hermeneutic phenomenology procedure. The study was conducted in hospitals affiliated with the Educational, Research and Treatment Centerwhich usually handle the NMMs. The sampling was purposeful with a maximum variation of eleven NMMs. Datawere collected using unstructured face-to-face interviews, and thetranscribed data were analyzed using Diekelmann, Allen, and Tanner's seven-stage thematic analysis approach. RESULTS: "Death-stricken survivor mother" was the central emerged theme, and three extracted sub-themes included: "Distorted psyche on a journey to death", "physical destruction due to an ominous event ", and the "vicissitudinous life after reviving ". These sub-themes, in turn, involved 12 sub-themes that emerged from 38 common meanings and 1200 codes. CONCLUSIONS: Findings demonstrate that the living conditions of NMMs are mixed in all aspects of the MNM event. They need a supportive program that includes additional follow-up visits, psychological support from the time of hospitalization until long-time after discharge, alleviation of social, sexual, and financial worries to return them to the normal life, as well as psychosocial rehabilitation to increase their life quality. Furthermore, post-discharge care in NMMs should be done actively and directly at their homes.


A maternal near miss (MNM) is a life-threatening condition experienced by a mother with organ failure due to severe maternal morbidity. Near miss mother (NMM) experiences adverse outcome such as physical, emotional, and psychological consequences after near miss event. Understanding the meaning of these mothers' lived experience and listening to their voices will help in reducing the burden of complications and will be effective in rehabilitating the disability created in their life. "Death-stricken survivor mother" was the central emerged theme resulting from the study of phenomenology. The main body of this theme reflects the severe physical, psychological burden and vicissitudes life. Server maternal morbidity due pregnancy and childbirth, have made NMM mother's life very different from those of normal mothers. The living conditions of these mothers are mixed in all aspects of the MNM event. Long-term physical and psychological damages they have endured, should be on the agenda of women's health policy makers to support them for years after discharge with integrated care.


Asunto(s)
Near Miss Salud , Complicaciones del Embarazo , Cuidados Posteriores , Femenino , Humanos , Madres , Alta del Paciente , Sobrevivientes
17.
Codas ; 34(3): e20210109, 2022.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-35019088

RESUMEN

PURPOSE: The aim of this study was to analyze the repercussion of the implementation of PECS on the burden index of mothers of children with Autism Spectrum Disorder (ASD). METHODS: This was a longitudinal study (CEP 0403/2017). The sample consisted of 20 mother and child with ASD. The mothers were on average 41 years and 5 months and the children were 7 years and 2 months old. Fifteen children were male and five were female. The brazilian version of the Burden Interview scale was applied to verify the level of caregiver burden. The Autism Behavior Checklist (ABC) was applied to the analysis of non-adaptive behaviors and to analyze the lexical repertoire: Auditory and Expressive Vocabulary Tests. The PECS Implementation Program was composed of 24 sessions of individual speech therapy with the active presence of mothers. At the end all children and mothers were reevaluated with part of the instruments. RESULTS: There was a tendency to reduce maternal overload indexes after the implementation of the PECS. There was a significant decrease in non-adaptive behaviors and an increase in the expressive and auditory vocabulary indexes of the children at the final moment of the study. We did not observe a significant correlation between the degrees of overload with age, schooling and intellectual quotient of children, nor schooling and maternal socioeconomic status. CONCLUSION: It was possible to analyze the repercussion of the implementation of the PECS on the burden of mothers of children with ASD assisted by the Program.


OBJETIVO: O objetivo deste estudo foi analisar a repercussão da implementação do PECS no índice de sobrecarga de mães de crianças com Transtorno do Espectro do Autismo (TEA). MÉTODO: Trata-se de um estudo longitudinal (CEP 0403/2017). A amostra foi constituída por 20 díades mães-crianças com TEA. As mães tinham em média, 41 anos e 5 meses e as crianças, 7 anos e 2 meses. Quinze crianças eram do gênero masculino e cinco, do feminino. Foi aplicada a versão brasileira da escala Burden Interview cujo objetivo é a verificação do nível de sobrecarga dos cuidadores. Para análise dos comportamentos não-adaptativos aplicou-se o Autism Behavior Checklist (ABC) e para análise do repertório lexical: os Testes de Vocabulário Auditivo e Expressivo. O Programa de Implementação do PECS foi composto por 24 sessões de terapia fonoaudiológica individual com a presença ativa das mães. Ao final do Programa todas as crianças e suas respectivas mães foram reavaliadas com parte dos instrumentos utilizados na fase inicial do estudo. RESULTADOS: Houve tendência de redução dos índices de sobrecarga materna após a implementação do PECS. Notamos diminuição significativa dos comportamentos não-adaptativos e aumento dos índices de vocabulário expressivo e auditivo das crianças no momento final do estudo. Não observamos correlação significativa entre os índices de sobrecarga com a idade, escolaridade e quociente intelectual das crianças; nem com a escolaridade e nível socioeconômico materno. CONCLUSÃO: Foi possível analisar a repercussão da implementação do PECS na sobrecarga de mães de crianças com TEA assistidas pelo Programa.


Asunto(s)
Trastorno del Espectro Autista , Equipos de Comunicación para Personas con Discapacidad , Niño , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Madres , Habla
18.
Pediatr Obes ; 17(1): e12833, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34327846

RESUMEN

BACKGROUND: Metabolomic analysis is commonly used to understand the biological underpinning of diseases such as obesity. However, our knowledge of gut metabolites related to weight outcomes in young children is currently limited. OBJECTIVES: To (1) explore the relationships between metabolites and child weight outcomes, (2) determine the potential effect of covariates (e.g., child's diet, maternal health/habits during pregnancy, etc.) in the relationship between metabolites and child weight outcomes, and (3) explore the relationship between selected gut metabolites and gut microbiota abundance. METHODS: Using 1 H-NMR, we quantified 30 metabolites from stool samples of 170 two-year-old children. To identify metabolites and covariates associated with children's weight outcomes (BMI [weight/height2 ], BMI z-score [BMI adjusted for age and sex], and growth index [weight/height]), we analysed the 1 H-NMR data, along with 20 covariates recorded on children and mothers, using LASSO and best subset selection regression techniques. Previously characterized microbiota community information from the same stool samples was used to determine associations between selected gut metabolites and gut microbiota. RESULTS: At age 2 years, stool butyrate concentration had a significant positive association with child BMI (p-value = 3.58 × 10-4 ), BMI z-score (p-value = 3.47 × 10-4 ), and growth index (p-value = 7.73 × 10-4 ). Covariates such as maternal smoking during pregnancy are important to consider. Butyrate concentration was positively associated with the abundance of the bacterial genus Faecalibacterium (p-value = 9.61 × 10-3 ). CONCLUSIONS: Stool butyrate concentration is positively associated with increased child weight outcomes and should be investigated further as a factor affecting childhood obesity.


Asunto(s)
Microbioma Gastrointestinal , Obesidad Pediátrica , Índice de Masa Corporal , Butiratos , Niño , Preescolar , Heces , Femenino , Humanos , Madres , Obesidad Pediátrica/epidemiología , Embarazo
19.
Environ Res ; 204(Pt A): 111908, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34425114

RESUMEN

BACKGROUND: Studies have documented independent adverse associations between prenatal and early-life exposure to environmental chemicals and social adversity with child neurodevelopment; however, few have considered these exposures jointly. The objective of this analysis is to examine whether associations of pesticide mixtures and adolescent neurobehavioral development are modified by early-life adversity in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort. METHODS: We used linear mixed effects Bayesian Hierarchical Models (BHM) to examine the joint effect of applications of 11 agricultural pesticides within 1 km of maternal homes during pregnancy and youth-reported Adverse Childhood Experiences (ACEs) with maternal and youth-reported internalizing behaviors, hyperactivity, and attention problems assessed via the Behavior Assessment for Children (BASC) (mean = 50, standard deviation = 10) at ages 16 and 18 years (n = 458). RESULTS: The median (25th-75th percentiles) of ACEs was 1 (0-3); 72.3% of participants had low ACEs (0-2 events) and 27.7% had ACEs (3+ events). Overall, there was little evidence of modification of exposure-outcome associations by ACEs. A two-fold increase in malathion use was associated with increased internalizing behaviors among those with high ACEs from both maternal- (ß = 1.9; 95% Credible Interval (CrI): 0.2, 3.7 for high ACEs vs. ß = -0.1; 95% CrI: 1.2, 0.9 for low ACEs) and youth-report (ß = 2.1; 95% CrI: 0.4, 3.8 for high ACEs vs. ß = 0.2; 95% CrI: 0.8, 1.2 for low ACEs). Applications of malathion and dimethoate were also associated with higher youth-reported hyperactivity and/or inattention among those with high ACEs. CONCLUSION: We observed little evidence of effect modification of agricultural pesticide use near the home during pregnancy and adolescent behavioral problems by child ACEs. Future studies should examine critical windows of susceptibility of exposure to chemical and non-chemical stressors and should consider biomarker-based exposure assessment methods.


Asunto(s)
Experiencias Adversas de la Infancia , Plaguicidas , Adolescente , Teorema de Bayes , Niño , Estudios de Cohortes , Femenino , Humanos , Madres , Plaguicidas/toxicidad , Embarazo
20.
Appetite ; 168: 105671, 2022 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34481013

RESUMEN

The quality of father-infant/toddler interactions has become a focal point in studies of early child development. However, studies targeting early father-infant/toddler interactions may be hampered due to the lack of specific and validated measures; indeed, most of the applied observational instruments were originally designed to evaluate mother-child interactions. In a sample of 142 fathers-infant/toddler dyads, the current study aimed to test the reliability of the Feeding and Play Scales, which were initially created to assess mother-infant/toddler interactions. Also, we compared the father-infant/toddler feeding and play interactions at different developmental stages, from 1 month to 3 years of the child's age, and we evaluated the effect of the child's gender on the father-infant/toddler feeding and play interactions. Both scales showed satisfactory internal consistency, confirming that the measures are reliable in the evaluation of father-infant/toddler feeding and play interactions. Analyses showed significant correlations between the subscales of the Feeding and Play Scales, significant effects of the child's age and significant gender differences. Our research shows that the Feeding and Play Scales are promising instruments to study the role of fathers in the development of normal and disordered feeding in infants and toddlers.


Asunto(s)
Padre , Madres , Preescolar , Estudios Transversales , Relaciones Padre-Hijo , Femenino , Humanos , Lactante , Masculino , Núcleo Familiar , Psicometría , Reproducibilidad de los Resultados
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