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1.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 22-39, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31918644

RESUMEN

The Emotional Competence of Mothers and the Clinical Quality of Mother-Child Relationship in a Preschool Psychiatric Population The quality of mother-child interaction and relationship is an essential risk factor for the development of mental disorders at preschool age. We examine maternal emotional competence and maternal level of psychopathology as predictors for the quality of mother-child relationship. At the beginning of their treatment a clinical sample of mother-child-dyads at the Child Psychiatric Family Day Hospital in Münster was assessed concerning the emotional competence of mothers (EKF), the maternal psychopathology (SCL) and the mother-child relationship quality, the latter with three different instruments reflecting the mother's, the child's and the therapist's perspective (PIR-GAS, SKEI, M-PCR). The mothers showed decreased results in the EKF scales emotional regulation, recognition of emotions and in the EKF-overall-score and presented a higher level of maternal psychopathology compared to the normal population. There is a direct relation between emotional regulation and the M-PCR scales affective bond and functional-conflict. Besides the direct influence of the maternal psychopathology, the expected moderator effect of emotional expressiveness and the M-PCR scale functional-conflict, reported by mothers, was apparent. Certain aspects of the emotional competence of mothers and their psychopathology show an influence on mother-child relationship quality. The method and the perspective of assessment are crucial to the results.


Asunto(s)
Emociones , Trastornos Mentales , Relaciones Madre-Hijo , Madres , Preescolar , Femenino , Humanos , Madres/psicología , Psicopatología
2.
BMJ ; 368: l6779, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31941696

RESUMEN

The studyChappell LC, Brocklehurst P, Green ME, et al. Planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX): a randomised controlled trial. Lancet 2019;394:1181-90.This project was funded by the NIHR Health Technology Assessment Programme (project number 12/25/03).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000838/mothers-benefit-from-a-planned-earlier-delivery-for-late-pre-eclampsia.


Asunto(s)
Preeclampsia , Nacimiento Prematuro , Femenino , Humanos , Recién Nacido , Madres , Embarazo , Evaluación de la Tecnología Biomédica , Espera Vigilante
4.
Codas ; 32(2): e20190093, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939494

RESUMEN

PURPOSE: The attitude of mothers of children who stutter is believed to be crucial in the management of therapy process. Therefore, this study aimed at the description of resilience, perceived social support and trait anxiety levels of mothers of children with stuttering, as well as at the exploration of the relationship between them. METHODS: The study sample consisted of 33 mothers of children with stuttering aged 6-12 years. The data were gathered using the following instruments: Mother Resilience Scale, Revised Parental Social Support Scale, State-trait Anxiety Inventory, Stuttering Severity Instrument-4, and a personal information form. RESULTS: Resilience of mothers of children who stutter was high, whereas perceived social support and trait anxiety levels of the participants were lower. Mother's increased level of perceived social support resulted in increased resilience level and decreased trait anxiety level. The trait anxiety levels of mothers with a college degree were significantly lower than those of mothers with other education levels. No statistically significant correlation was observed between stuttering severity and the levels of resilience, perceived social support and trait anxiety. CONCLUSION: Although mothers of stuttering children present the required skills to cope with the situation, it is believed that they need more social support. Consequently, offering professional support to mothers in the course of stuttering management and referring them to appropriate intervention programs are emphasized.


Asunto(s)
Ansiedad/psicología , Madres/psicología , Resiliencia Psicológica , Apoyo Social , Tartamudeo/psicología , Adulto , Niño , Escolaridad , Femenino , Humanos , Masculino , Relaciones Madre-Hijo/psicología , Percepción , Escalas de Valoración Psiquiátrica , Valores de Referencia , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Turquia
5.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 50-55, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31123055

RESUMEN

OBJECTIVE: Higher rates of neonatal morbidity and mortality at term combined with earlier spontaneous delivery have led to the hypothesis that babies born to South Asian born (SA-born) women may mature earlier and/or their placental function decreases earlier than babies born to Australian and New Zealand born (Aus/NZ-born) women. Whether babies born to SA-born women do better in the preterm period, however, has yet to be evaluated. In this study we investigated respiratory outcomes, indicative of functional maturity, of preterm babies born to SA-born women compared with those of Aus/NZ-born women to explore this hypothesis further. STUDY DESIGN AND SETTING: This retrospective cohort study was conducted at Monash Health. PATIENTS: Data were collected from neonatal and birth records of moderate-late preterm (32-36 weeks) infants born between 2012 and 2015 to SA-born and Aus/NZ-born women. OUTCOME MEASURES: Rates of nursery admissions and neonatal respiratory outcomes were compared. RESULTS: Babies born to Aus/NZ-born women were more likely to be admitted to a nursery (80%) compared with SA-born babies (72%, p=0.004). Babies born to SA-born mothers experienced significantly less hyaline membrane disease (7.8%), required less resuscitation at birth (28.6%) and were less likely to require ventilation (20%) than babies born to Aus/NZ-born mothers (18%, 42.2%, 34.6%; p<0.001). There was no difference in the duration of ventilation or length of stay in hospital. CONCLUSIONS: Moderate-late preterm babies born to SA-born women appear to have earlier functional maturity, as indicated by respiratory outcomes, than Aus/NZ-born babies. Our findings support the hypothesis of earlier fetal maturation in SA-born women.


Asunto(s)
Grupo de Ascendencia Continental Asiática , Grupo de Ascendencia Continental Europea , Enfermedad de la Membrana Hialina/epidemiología , Nacimiento Prematuro , Resucitación/estadística & datos numéricos , Adulto , Asia Sudoriental/etnología , Australia , Peso al Nacer , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Glucocorticoides/uso terapéutico , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Madres , Nueva Zelanda , Admisión del Paciente/estadística & datos numéricos , Atención Prenatal , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos
6.
Lancet ; 394(10216): 2283-2284, 2020 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-31868634
8.
Int J Gynaecol Obstet ; 148(1): 27-34, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31544243

RESUMEN

OBJECTIVE: Despite the recognized importance of person-centered care, very little information exists on how person-centered maternity care (PCMC) impacts newborn health. METHODS: Baseline and follow-up data were collected from women who delivered in government health facilities in Nairobi and Kiambu counties in Kenya between August 2016 and February 2017. The final analytic sample included 413 respondents who completed the baseline survey and at least one follow-up survey at 2, 6, 8, and/or 10 weeks. Data were analyzed using descriptive, bivariate, and multivariate statistics. Logistic regression was used to assess the relationship between PCMC scores and outcomes of interest. RESULTS: In multivariate analyses, women with high PCMC scores were significantly less likely to report newborn complications than women with low PCMC scores (adjusted odds ratio [aOR] 0.39, 95% confidence interval [CI] 0.16-0.98). Women reporting high PCMC scores also had significantly higher odds of reporting a willingness to return to the facility for their next delivery than women with low PCMC score (aOR 12.72, 95% CI 2.26-71.63). The domains of Respect/Dignity and Supportive Care were associated with fewer newborn complications and willingness to return to a facility. CONCLUSION: PCMC could improve not just the experience of the mother during childbirth, but also the health of her newborn and future health-seeking behavior.


Asunto(s)
Servicios de Salud Materna/organización & administración , Atención Dirigida al Paciente/métodos , Resultado del Embarazo/epidemiología , Adulto , Femenino , Humanos , Recién Nacido , Kenia , Servicios de Salud Materna/estadística & datos numéricos , Madres/psicología , Oportunidad Relativa , Atención Dirigida al Paciente/estadística & datos numéricos , Embarazo , Encuestas y Cuestionarios
9.
Sci Total Environ ; 699: 134385, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31678881

RESUMEN

The aim of the present study was to assess the exposure to pesticides in urine from Spanish lactating mothers (n = 116). Six nonspecific (dialkyl phosphates) and 20 specific metabolites of organophosphate pesticides (OPs), herbicides and pyrethroids were analyzed. The most frequently detected biomarkers were diethyl phosphate, p-nitrophenol, 3,5,6-trichloro-2-pyridinol and 3-phenoxybenzoic acid, whose geometric means were 1.9 ng·mL-1, 0.8 ng·mL-1, 1.5 ng·mL-1 and 1.4 ng·mL-1, respectively. Herbicide metabolites were the least frequently detected biomarkers with detection frequencies between 0% (2,4,5-Trichlorophenoxyacetic acid) and 22% (2,4-Dichlorophenoxyacetic acid). Multiple regression analyses showed that the closeness to a farming activity, the place of residence and the presence of garden/plants at home were some of the most important contributors to urinary levels of pesticide metabolites. Estimated daily intake (EDI), hazard quotient (HQ) and hazard index (HI) were obtained in order to interpret urinary levels of the most frequently detected pesticide metabolites in a risk assessment context. The highest EDIs were obtained for chlorpyrifos (0.40-1.14 µg·kg bw-1·day-1) and deltamethrin (0.34-4.73 µg·kg bw-1·day-1). The calculated HQ for chlorpyrifos, dimethoate, parathion and deltamethrin ranged from 0.01 to 0.47, and HI for OPs ranged from 0.09 to 0.33 showing that apparently there were low health risks due to the exposure to these pesticides in this group of Spanish breastfeeding women.


Asunto(s)
Monitoreo del Ambiente , Contaminantes Ambientales/orina , Exposición Materna/estadística & datos numéricos , Plaguicidas/orina , Adulto , Femenino , Humanos , Lactancia , Madres
12.
BJOG ; 127(2): 217-227, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31006170

RESUMEN

OBJECTIVE: To evaluate the potential impact of intrapartum antibiotics, and their specific classes, on the infant gut microbiota in the first year of life. DESIGN: Prospective study of infants in the New Hampshire Birth Cohort Study (NHBCS). SETTINGS: Rural New Hampshire, USA. POPULATION OR SAMPLE: Two hundred and sixty-six full-term infants from the NHBCS. METHODS: Intrapartum antibiotic use during labour and delivery was abstracted from medical records. Faecal samples collected at 6 weeks and 1 year of age were characterised by 16S rRNA sequencing, and metagenomics analysis in a subset of samples. EXPOSURES: Maternal exposure to antibiotics during labour and delivery. MAIN OUTCOME MEASURE: Taxonomic and functional profiles of faecal samples. RESULTS: Infant exposure to intrapartum antibiotics, particularly to two or more antibiotic classes, was independently associated with lower microbial diversity scores as well as a unique bacterial community at 6 weeks (GUnifrac, P = 0.02). At 1 year, infants in the penicillin-only group had significantly lower α diversity scores than infants not exposed to intrapartum antibiotics. Within the first year of life, intrapartum exposure to penicillins was related to a significantly lower increase in several taxa including Bacteroides, use of cephalosporins was associated with a significantly lower rise over time in Bifidobacterium and infants in the multi-class group experienced a significantly higher increase in Veillonella dispar. CONCLUSIONS: Our findings suggest that intrapartum antibiotics alter the developmental trajectory of the infant gut microbiome, and specific antibiotic types may impact community composition, diversity and keystone immune training taxa. TWEETABLE ABSTRACT: Class of intrapartum antibiotics administered during delivery relates to maturation of infant gut microbiota.


Asunto(s)
Profilaxis Antibiótica , Heces/microbiología , Microbioma Gastrointestinal/efectos de los fármacos , Vagina/microbiología , Bacteroides/crecimiento & desarrollo , Bacteroidetes , Bifidobacterium , Femenino , Humanos , Recién Nacido , Lactobacillus , Exposición Materna , Madres , Embarazo , Estudios Prospectivos , ARN Ribosómico 16S , Análisis de Secuencia de ARN , Nacimiento a Término , beta-Lactamasas
13.
BJOG ; 127(2): 129-137, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31325209

RESUMEN

The hologenome concept of evolution is discussed, with special emphasis placed upon the microbiome of women. The microbiome is dynamic, changing under different conditions, and differs between women and men. Genetic variation occurs not only in the host, but also in the microbiome by the acquisition of novel microbes, the amplification of specific microbes, and horizontal gene transfer. The majority of unique genes in human holobionts are found in microbiomes, and mothers are responsible for transferring most of these to their offspring during birth, breastfeeding, and physical contact. Thus, mothers are likely to be the primary providers of the majority of genetic information to offspring via mitochondria and the microbiome. TWEETABLE ABSTRACT: Microbiomes differ between women and men. Most genes in humans are in the microbiome. Mothers transfer most of these genes to offspring.


Asunto(s)
Adaptación Biológica/fisiología , Adaptación Fisiológica/fisiología , Transferencia de Gen Horizontal/genética , Interacciones Microbiota-Huesped/fisiología , Microbiota/fisiología , Madres , Adaptación Biológica/genética , Adaptación Fisiológica/genética , Adulto , Animales , Evolución Biológica , Evolución Molecular , Femenino , Especiación Genética , Variación Genética , Herencia , Humanos , Masculino , Microbiota/genética , Plantas , Embarazo
15.
Harefuah ; 158(12): 826-831, 2019 Dec.
Artículo en Hebreo | MEDLINE | ID: mdl-31823540

RESUMEN

INTRODUCTION: Preventive medical services for mothers and infants or "Tipat Halav" (Mother & Child clinics) - as they have been known since the earliest times in Eretz Yisrael (pre-statehood Israel) - have been based over many years on a tradition of quality service that assures public health in Israel. This paper presents the policy and services over the years and highlights its contribution to the development of preventive medicine in Israel. This is due to the renewed debate concerning the existence of preventive services within the structure of the health system, and also for the sake of historical truth. The material presented here is based on the examination of documents and research studies conducted within the medical services in years that were fateful for public health in Israel. Two medical institutions - Hadassah and Clalit Health Services (known as Kupat Holim Clalit until 1995) - laid the foundations for the health system in Eretz Yisrael at a time when health-promoting measures consisted of no more than treating illness and preventing infections and the spread of epidemics. In the years before statehood in 1948, mortality rates in Eretz Yisrael were falling. Infant mortality, had declined to 48 deaths per 1,000 live births, was one of the world's lowest rates. It was a significant improvement, since in 1927, for example, infant mortality in Eretz Yisrael had reached 108 per 1,000 live births - one of the world's highest rates at the time. These dramatically improved statistics resulted from the development of Jewish health services in Eretz Yisrael during the British Mandate period. With the declaration of Israel's independence, Hadassah and Kupat Holim Clalit were the chief factors supplying neonatal services in Israel. Following statehood, the Ministry of Health started acting as the state organ that supervised all those entities. In the 1990s, following the recommendations of the Netanyahu Committee that had been appointed to examine the health system, and according to whose recommendations the State Health Law was legislated in 1995, it was decided to transfer preventive personal medical services (Mother & Child) to the various health funds, and to leave the Ministry of Health with a purely supervisory role. In the final decade of the previous century, and in the early years of the present one, that same recommendation was repeated by additional committees and other professional bodies but has still not been implemented.


Asunto(s)
Servicios de Salud Materno-Infantil , Servicios Preventivos de Salud , Niño , Femenino , Humanos , Lactante , Mortalidad Infantil , Israel , Judíos , Madres
16.
Niger J Clin Pract ; 22(12): 1662-1668, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793471

RESUMEN

Background: Postpartum fatigue means tiredness, sense of suffocation, and decreased physical and mental capacity. Fatigue reduces postpartum women's ability of concentrate, which may increase the frequency of postpartum depression, and their babies and cause babies' weaning off breastmilk earlier. Aim: Postpartum fatigue reduces the ability of mothers to concentrate and has a negative effect on communication between mothers and their babies. This study was performed to determine the effect of fatigue on breastfeeding and breastfeeding behaviors in postpartum women. Subjects and Methods: The study had a descriptive desing and was carreid out in a postpartum clinic of a maternal, obstetric, and pediatric diseases hospital. It included 374 women giving normal vaginal birth. Data were gathered with a socio-demographic features form and Visual Analogue Scale for Fatigue. Results: The mean score was 6,91 ± 2,25 for the subscale fatigue and 2,38 ± 0,91 for the subscale energy. The women reporting that it was not difficult to give birth and that they had little or some fatigue had significantly higher scores for energy (P = 0.001). The women starting to breastfeed in the hour of giving birth (P = 0.003) and the women breastfeeding at 1-hour intervals (P = 0.100) had a lower score for fatigue. The women not needing help while breastfeeding had a significantly lower score for fatigue (P = 0.001), while those reporting to give additional food had a significantly higher score for fatigue (P = 0.014). Conclusion: Women feel tired in the early postpartum period due to giving birth and their tiredness is increased by breastfeeding and infant care.


Asunto(s)
Lactancia Materna/psicología , Fatiga/complicaciones , Madres/psicología , Periodo Posparto/psicología , Adulto , Parto Obstétrico , Depresión Posparto , Fatiga/psicología , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Encuestas y Cuestionarios , Turquia
18.
Environ Health Prev Med ; 24(1): 74, 2019 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-31812162

RESUMEN

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION: Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/etiología , Exposición Materna/efectos adversos , Efectos Tardíos de la Exposición Prenatal/etiología , Fumar Tabaco/efectos adversos , Adulto , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Preescolar , Cotinina/sangre , Femenino , Estudios de Seguimiento , Humanos , Japón/epidemiología , Masculino , Madres , Embarazo , Tercer Trimestre del Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Riesgo , Factores Sexuales , Fumar Tabaco/epidemiología
20.
RECIIS (Online) ; 13(4): 911-921, out.-dez. 2019. ilus
Artículo en Portugués | LILACS | ID: biblio-1047676

RESUMEN

Uma vez que a internet assumiu o papel de fonte preferencial e espontânea de acesso à informação, o objetivo deste estudo é sintetizar o que as mães brasileiras buscam e encontram na internet sobre aleitamento materno, por meio de revisão crítica da literatura científica dos últimos 10 anos. Os estudos selecionados permitiram a categorização de três tópicos de discussão: qualidade das informações disponíveis; desenvolvimento de facilitadores para acesso a informações sobre aleitamento materno; e grupos virtuais de apoio à amamentação como espaço de educação em saúde. A internet é uma área com grande potencial para o desenvolvimento de ações de educação em saúde e promoção do aleitamento materno. Apesar de pertinente e atual, a literatura científica carece de pesquisas que explorem o tema do aleitamento materno sob o ponto de vista da interação on-line das mães, sendo este um campo muito rico para estudos futuros.


Since the internet has assumed the role of a preferential and spontaneous source of access to information, this work intends to synthesize what Brazilian mothers search and find on the internet about breastfeeding through a Critical Review of Literature in the last 10 years. The selected studies have allowed for the categorization of three discussion topics: quality of information available, development of facilitators for access to information on breastfeeding and virtual groups supporting breastfeeding as a space for health education. The internet is an area with great potential for the development of actions of health education and promotion of breastfeeding. Although pertinent and current, the scientific literature lacks research that explores the topic of breastfeeding from the perspective of the online interaction of mothers, which is a very rich field for future studies.


El objetivo de este estudio es sintetizar lo que las madres brasileñas buscan y encuentran en internet sobre lactancia materna, por medio de una revisión crítica de la literatura científica de los últimos 10 años. Los estudios seleccionados permitieron la categorización de tres temas de discusión: calidad de la información disponible; desarrollo de facilitadores para acceso a informaciones sobre lactancia materna y grupos virtuales de apoyo a la lactancia como espacio de educación en salud. La internet es un área con gran potencial para el desarrollo de acciones de educación en salud y promoción de la lactancia materna. A pesar de pertinente y actual, la literatura científica carece de investigaciones que exploren el tema de la lactancia materna desde el punto de vista de la interacción online de las madres, siendo este un campo muy rico para estudios futuros.


Asunto(s)
Humanos , Lactancia Materna , Salud Materno-Infantil , Internet , Tecnología Biomédica , Promoción de la Salud , Socialización , Mujeres , Revisión , Responsabilidad Parental , Nutrición del Lactante , Medios de Comunicación Sociales , Madres
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