Mães no período de situação pandémica por COVID-19: Das vivências às narrativas / Mothers during the COVID-19 pandemic: From experiences to narratives / Madres durante la pandemia de COVID-19: De las experiencias a los relatos

Resumo Enquadramento: A pandemia por COVID-19 trouxe inúmeros desafios às mães de crianças e jovens até aos 18 anos de idade, pela gestão de responsabilidades a que o seu papel social se encontra inerente. Objetivo: Compreender quais são os significados e os contextos das vivências de mães portuguesas de crianças e jovens adolescentes até aos 18 anos de idade, no período de situação pandémica por COVID-19; Metodologia: Estudo qualitativo, descritivo e retrospetivo recorrendo à análise de conteúdo de Bardin. Participaram no estudo 16 mulheres, mães de crianças e jovens adolescentes até aos 18 anos de idade. Resultados: Emergiram um total de nove categorias, sendo elas - Sentimentos; Perceção de saúde; Alterações no estado de saúde; experiências marcantes; Significado das experiências; Dificuldades sentidas durante o período de situação pandémica; dificuldades sentidas na educação; dificuldades sentidas enquanto mãe e mulher e impactos na educação dos filhos. Conclusão: A maioria das mães entrevistadas considerou o período pandémico por COVID-19 como uma fase impactante nas suas vidas, originando ambivalência de sentimentos e contextos vivenciais distintos.

Abstract Background: The COVID-19 pandemic has posed many challenges for mothers of children and adolescents up to 18 years of age in managing the responsibilities associated with their social roles. Objective: To understand the meanings and contexts of the experiences of Portuguese mothers of children and adolescents up to 18 years of age during the COVID-19 pandemic. Methodology: Qualitative, descriptive, and retrospective study using Bardin's content analysis. The sample consisted of 16 mothers of children and adolescents up to 18 years of age. Results: Nine categories emerged - Feelings; Perception of health; Changes in health status; Significant experiences; Meaning of experiences; Difficulties felt during the pandemic; Difficulties felt in education; Difficulties felt as a mother and wife; and Impact on children's education. Conclusion: Most of the interviewed mothers considered the COVID-19 pandemic a significant period in their lives, giving rise to ambivalent feelings and distinct life contexts.

Resumen Marco contextual: La pandemia de SARS- CoV-2 ha planteado numerosos retos a las madres de niños y jóvenes de hasta 18 años, debido a la gestión de las responsabilidades inherentes a su papel social. Objetivo: Comprender los significados y contextos de las experiencias de las madres portuguesas de niños y jóvenes adolescentes de hasta 18 años, durante la situación de pandemia de COVID-19. Metodología: Estudio cualitativo, descriptivo y retrospectivo mediante el análisis de contenido de Bardin. Participaron en el estudio 16 mujeres, madres de niños y jóvenes adolescentes de hasta 18 años. Resultados: Surgieron un total de nueve categorías - Sentimientos; Percepción de la salud; Cambios en el estado de salud; Experiencias notables; Significado de las experiencias; Dificultades sentidas durante la situación de pandemia; Dificultades sentidas en la educación; Dificultades sentidas como madre y esposa, e Impactos en la educación de los hijos. Conclusión: La mayoría de las madres entrevistadas consideraron que el periodo de la pandemia de COVID-19 fue una fase impactante en sus vidas, lo que dio lugar a una ambivalencia de sentimientos y diferentes contextos experienciales.

Vulnerability to depression and resolution in mothers of children with cerebral palsy.

BACKGROUND: This study investigated associations between Self-Criticism and Dependency as factors of vulnerability to depression and maternal resolution. Resolution entails parental cognitive and emotional acceptance of the child's developmental disability. METHODS: Our sample included 100 mothers whose children had a diagnosis of cerebral palsy. The Reaction to Diagnosis Interview, the Depressive Experiences Questionnaire and the Depression Scale were administered. RESULTS: The results showed that unresolved mothers scored higher on the dimensions of Self-Criticism and Dependency compared to their resolved counterparts. The hierarchical cluster analysis yielded three maternal profiles based on the scores obtained on the dimensions of vulnerability to depression, regardless of maternal resolution status. The first profile was labeled Low Vulnerability and was characterized by low scores on Self-Criticism and Dependency. The second profile was labeled Dependent and it included mothers with higher scores on Dependency and lower scores on Self-Criticism. The third profile comprised mothers with higher scores on both Self-Criticism and Dependency. The smallest proportion of unresolved mothers belonged to the third, most vulnerable profile labeled Double Vulnerability. DISCUSSION: We discussed the implications of the obtained results in light of a need for psychotherapeutic interventions that would focus on individual differences when providing support to parental resolution.

Prenatal phthalate exposure and pubertal development in 16-year-old daughters: reproductive hormones and number of ovarian follicles.

STUDY QUESTION: Is there a possible association between prenatal phthalate exposure and late effects in teenage daughters with respect to reproductive hormone levels, uterine volume, and number of ovarian follicles? SUMMARY ANSWER: Our study showed subtle associations between phthalate metabolite concentrations in maternal serum from pregnancy or cord blood and LH and insulin-like growth factor 1 (IGF-1) levels as well as uterine volume in their daughters 16 years later. WHAT IS KNOWN ALREADY: Endocrine-disrupting environmental chemicals may adversely affect human reproductive health, and many societies have experienced a trend toward earlier puberty and an increasing prevalence of infertility in young couples. The scientific evidence of adverse effects of foetal exposure to a large range of chemicals, including phthalates, on male reproductive health is growing, but very few studies have explored effects on female reproduction. STUDY DESIGN, SIZE, DURATION: This follow-up study included 317 teenage daughters who were part of the Copenhagen Mother-Child Cohort, a population-based longitudinal birth cohort of 1210 females born between 1997 and 2002. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 317 female participants (median age 16 years) were examined for weight, height, and menstrual pattern. A serum sample was analysed for concentrations of reproductive hormones, and trans-abdominal 3D ultrasonography was performed to obtain the number of ovarian follicles, ovarian and uterine size. Prenatal maternal serum samples were available for 115 females, and cord blood samples were available for 118 females. These were analysed for concentrations of 32 phthalate metabolites. Weighted quantile sum regression was used for modelling associations of combined prenatal phthalate exposure with the reproductive outcomes in post-menarcheal females. MAIN RESULTS AND THE ROLE OF CHANCE: In bivariate correlation analyses, negative significant associations were found between several prenatal phthalate metabolite concentrations and serum hormone concentrations (testosterone, 17-OH-progesterone, and IGF-1) as well as number of ovarian follicles in puberty. Positive significant correlations were found between prenatal phthalate exposure and FSH and sex hormone-binding globulin concentrations. Combined analyses of phthalate exposure (weighted quantile sums) showed significant negative associations with IGF-1 concentration and uterine volume as well as a significant positive association with LH concentration. LIMITATIONS, REASONS FOR CAUTION: Phthalate metabolites were measured in serum from single prenatal maternal blood samples and cord blood samples. Potential concomitant exposure to other endocrine-disrupting environmental chemicals before or after birth was not controlled for. The study population size was limited. WIDER IMPLICATIONS OF THE FINDINGS: Our results support the need for further research into possible adverse effects of environmental chemicals during foetal development of the female reproductive system. STUDY FUNDING/COMPETING INTEREST(S): The work was supported by The Center on Endocrine Disruptors (CeHoS) under The Danish Environmental Protection Agency and The Ministry of Environment and Food (grant number: MST-621-00 065). No conflicts of interest are declared. TRIAL REGISTRATION NUMBER: N/A.

Relationship between Maternal Prenatal Vitamin D Status and Early Childhood Caries in Their Children: A Cross-sectional Survey.

Background: Vitamin D deficiency in expectant mothers is very common in India. As a consequence, the possibility of hypoplasia of teeth and resultant propensity for faster progression of early childhood caries (ECC) is expected to be higher in Indian children. Aim: This study aimed to determine the relationship between prenatal vitamin D intake of mothers and dental caries experience in their preschool children, and whether vitamin D deficiency in mothers could be a risk factor for tooth decay in their children. Design: This cross-sectional study included 120 mothers of children aged up to 71 months with dental caries attending the Department of Pediatric Dentistry in India. Mothers were surveyed about their prenatal vitamin D intake and their practices regarding vitamin D and sunlight exposure. Children were clinically examined, and their caries status was recorded using the decayed, extracted, filled teeth (deft) index. Results: Data were analyzed descriptively and correlated using an independent t-test. Binary logistic regression was employed to predict the effects of the duration of sun exposure and vitamin D deficiency on dental decay. The correlation of mothers' prenatal vitamin D intake was significantly associated weekly with children's caries experience. Their sun exposure (p = 0.002) and practices adopted (p = 0.0001) regarding vitamin D levels were statistically significant for children's caries status. Improper brushing frequency was also significantly associated with higher deft scores. Conclusion: The association between mothers' prenatal vitamin D intake and health practices related to vitamin D with dental caries was not confirmed. Subjects with vitamin D deficiency and their children had significantly higher odds of developing dental decay. However, our findings suggest that 25-hydroxyvitamin D insufficiency may be a risk factor for developing dental caries in children. How to cite this article: Kalra G, Kumar Y, Langpoklakpam C, et al. Relationship between Maternal Prenatal Vitamin D Status and Early Childhood Caries in Their Children: A Cross-sectional Survey. Int J Clin Pediatr Dent 2024;17(8):860-863.

Utilization of birth companionship and its associated factors among laboring mothers during facilities birth in sub-Saharan Africa. Systematic review and meta-analysis.

Introduction: Birth companionship is one strategy for improving maternal and neonatal quality of care, as well as their outcomes. It is a low-cost and effective care that provide mothers with evidence-based practices throughout labor and delivery in health facilities. WHO has suggested that birth companionship can be given by a family member, spouse, friend, and doula. They support laboring mothers by offering comfort via touch, massage, warm baths, encouraging mobility, promoting fluid intake and output, supplying information about the status of labor and suggestions for coping strategies, and providing a communication channel between mothers and their caregivers that helps to reduce mother and newborn mortality on a globally and regionally. Despite this benefit, no systematic review and meta-analysis studies have been conducted on this topic in study area. Therefore, this study may give the pooled utilization and associated factors of birth companionship among laboring mothers during facility birth in Sub-Saharan Africa. Methods and materials: A systematic review and meta-analysis was conducted using preferred reporting items for systematic review and meta-analysis guidelines. Data base such as PubMed with Medline, Cochrane library, direct science, google scholar and different gray works of literature/email were used on the utilization of birth companionship and associated factors of studies from 2010 to 2023 in sub-Saharan Africa. A weighted inverse variance random effect model with DerSimonian-Laird method was used to estimate pooled utilization of birth companionship Cochrane Q-test, I 2, and p-value were computed to detect heterogeneity. Egger test and funnel plot were used to detect the evidence of publication bias. We did subgroup analysis, sensitivity analysis, and meta regression to identify source heterogeneity. The protocol has been registered in PROSPERO database "CRD42024503048." Results: In sub-Saharan Africa, laboring mothers giving delivery in a facility utilized birth companionship at a rate of 34% (95% CI: 26-42, I 2 = 98.90%, p < 0.01). Subgroup analysis revealed that South Africa had the largest pooled utilization of birth companionship (49%), while Rwanda had the lowest (14.5%). Having ANC (AOR = 2.69, 95% CI: 1.66-3.73, I 2 = 10.36%), having an obstetric complication (AOR = 2.55, 95% CI: 1.69-3.4, I 2 = 0%), desiring birth companionship (AOR = 2.46, 95% CI: 1.17-3.74, I 2 = 38.46%), and being prime para (AOR = 2.51, 95% CI: 1.83-3.19, I 2 = 0%) were significantly associated with pooled utilization of birth companionship. Conclusions: There is low pooled utilization of birth companionship among laboring mothers giving delivery in an institution in sub-Saharan Africa. Factors linked to the use of birth companionship included being primipara, having antenatal care, having complications during pregnancy, and desiring companionship. The management team and healthcare personnel must take the initiative to educate mothers during antenatal care about the benefits of having a birth companion.

Chinese mothers use idioms in shared book reading: A predictor for children's Chinese vocabulary growth?

Idioms play an important role in language; however, little research has examined idioms in children's natural language settings. This study explored idioms usage in maternal talk during mother-child shared book reading and its relation to children's vocabulary development. Thirty-three Chinese children in Norway (aged 3;0-5;5) and their mothers participated. We observed shared reading at the onset of the study and assessed children's receptive and expressive vocabulary in Chinese three times across one year. Results demonstrated that mothers used an average of 1.8 idioms and explained one-third of the idioms. Maternal idiom usage was correlated with their talk amount and lexical diversity. Individual growth modeling revealed that the number of idioms mothers used predicted the growth of children's receptive vocabulary in Chinese. We speculate that idiom usage could be an effective and understudied marker of parental linguistic sophistication. This study underscores the importance of idiom exposure in children's language environment.

Exploring risk factors for undernutrition in children aged under five years in Yemen.

BACKGROUND: Undernutrition is a global health concern, particularly in low-income countries, and can manifest as wasting, stunting and/or underweight. In Yemen, the recent armed conflict is likely to have significantly increased the incidence of undernutrition in young children, particularly those living in communities that were already experiencing socioeconomic and health disparities. AIM: To explore the risk factors associated with wasting, stunting and underweight in children aged between six months and five years living in one district of Yemen. METHOD: A cross-sectional study was conducted using a two-part questionnaire to collect anthropometric measurements and sociodemographic characteristics of children enrolled on an outpatient programme for undernourished children at three healthcare facilities in the Jiblah district, and of their families and households. RESULTS: Of the 120 children included in the study, 58 (48%) had wasting, 27 (23%) had stunting and 35 (29%) were underweight. Risk factors for undernutrition included being under the age of three years, being a girl, having had a low birthweight, having siblings under the age of five years, having a mother who is a housewife, living in a household relying on unimproved sources of drinking water, living in a rural area, and living in a low-income household. CONCLUSION: The nutritional status of children in Yemen is under continuing threat. The identification of risk factors for undernutrition may increase awareness of the issue and influence the policy decisions of the international community.

Peer-to-Peer Human Milk Sharing Through Social Media Groups: The Experiences of Women Donors and Recipients in Hong Kong.

AIM: To explore the lived experience of donors and recipients involved in peer-to-peer human milk donation. DESIGN: An exploratory descriptive qualitative study. METHOD: Semi-structured interviews were conducted between November 2022 and April 2023. A total of 50 women consisting of 34 donors and 16 recipients were recruited using purposive sampling from specific social media groups in Hong Kong that focus on breast milk donation and sharing. Data were analysed based on thematic analysis. RESULTS: Five key themes were identified in this study: Motivation; Milk sharing as a social act; Not a Norm; Recommendation to formal milk banks; and Formal donation as the preferred route. CONCLUSION: The findings indicate informal milk sharing is seen as an inferior alternative to formal milk donation systems. The establishment of formal milk banks is viewed as a way to address the shortcomings of informal sharing. IMPLICATIONS FOR THE PROFESSION: The findings have implications for the healthcare field, particularly in improving the experiences of those involved in informal milk sharing. The insights gained from the experiences of informal milk sharers can directly inform and enhance the services provided by formal milk banks. IMPACT: Given the growing prevalence of online informal milk sharing, healthcare professionals should enhance their understanding of this practice. However, the practice has remained understudied, particularly in Asian region. This study brings together the experiences of both milk donors and recipients, providing a comprehensive view on the phenomenon. REPORTING METHOD: The Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development of a complex intervention to strengthen municipality-based breastfeeding support to reduced social inequity in breastfeeding.

BACKGROUND: Breastfeeding is the ideal nutrition for infants and protects infants and mothers from a range of adverse health outcomes during their lifespan. In Denmark, while the breastfeeding initiation rate is high, only 14% of mothers meet the World Health Organization's recommendation of exclusive breastfeeding at six months. Furthermore, a notable social inequity exists among those who achieve this recommendation. Knowledge of effective interventions to reduce breastfeeding inequity is limited. A previous hospital-based intervention succeeded in increasing breastfeeding duration. However, most breastfeeding support is provided in Danish municipalities by health visitors. This called for adapting the intervention to the health visiting program and developing an intensified intervention addressing the social inequity in breastfeeding. This article describes the adaptation and development process of a municipality-based intervention. METHODS: During a 15-month period in 2020-21, the municipal intervention was iteratively developed using a three-stage framework for developing complex health interventions described by Hawkins et al. The three stages were 1) need assessment and stakeholder consultation, 2) co-production and 3) prototyping. The process was inspired by O'Cathain et al.'s principles for a user-centred, co-created and theory- and evidence-based approach, involving parents and health visitors. RESULTS: In stage 1, we identified the needs and priorities of the target groups of the intervention. In stage 2, the intervention was developed through action research design and inspired by Duus' 'learning cycles' as the method to enhance motivation and ownership and to strengthen the implementation process by creating a joint room for learning and reflection with health visitors and developers. In stage 3, the intervention was tested for feasibility and usefulness during a 2.5-month period accompanied by monthly dialogue meetings with health visitors and developers. In this period, the intervention was refined based on the gathered experiences and was subsequently prepared for evaluation. CONCLUSION: The description of the development of this complex intervention, aimed at increasing breastfeeding duration and reducing inequity, offers breastfeeding practitioners and researchers a transparent foundation for continuously improving breastfeeding support and a methodology for complex intervention development. TRIAL REGISTRATION: Registered at Clinical Trials NCT05311631.

Undernutrition and associated factors among lactating mothers in Chiro district, eastern Ethiopia: a community-based cross-sectional study.

Background: Maternal undernutrition during lactation is a worldwide public health problem. It causes impaired cognitive ability, poor productivity, irreversible loss, and intergenerational malnutrition, which has harmful effects on the next generation. Overall, there is little information on undernutrition and risk factors among lactating mothers, especially in resource-poor settings, including Ethiopia. This study assessed undernutrition and associated factors among lactating mothers in rural Chiro district, eastern Ethiopia. Method: A community-based cross-sectional study was conducted among 629 lactating mothers in the Chiro district from July 2-30, 2019. Data were collected from participants using pretested, structured questionnaires and anthropometric measurements. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27. Multivariable logistic regression analyses were used to identify factors associated with undernutrition. Results: Undernutrition among lactating mothers was 26.9% (95% CI: 23.2%, 30.2%). Female-headed household (AOR = 0.34, 95% CI:0.13, 0.94), medium (AOR = 0.58, 95% CI: 0.38, 0.95) and rich (AOR = 0.30, 95% CI: 0.18, 0.51) wealth quintiles, lack of dietary advice (AOR = 1.62, 95% CI: 1.10, 2.39), chewing khat (AOR = 1.82, 95% CI: 1.23, 2.70), low dietary diversity (AOR = 3.10, 95% CI: 1.82, 5.29), and household food insecurity (AOR = 3.67, 95% CI:1.47, 9.20) were factors significantly associated with undernutrition. Conclusions: Around one in every four lactating mothers in rural eastern Ethiopia had undernutrition. Poor wealth, lack of dietary feeding advice, substance use disorder, low minimum dietary diversity, and household food insecurity were factors significantly associated with the undernutrition of lactating mothers. Thus, focusing on implementing existing strategies/programs for effective nutritional interventions and poverty alleviation that enhance food security status would be essential to improving the nutritional status of lactating mothers and children.

Barriers and facilitators to healthy eating during post-partum among non-Hispanic Black mothers.

Maternal diet is a key predictor of child diet, yet an in-depth inquiry into the barriers and facilitators for the adoption of healthy eating behaviours during the post-partum period is lacking, specifically for non-Hispanic Black mothers. This study used qualitative research methods to investigate healthy eating practices among a sample of non-Hispanic Black mothers participating in a family-based obesity prevention intervention. In-depth interviews were conducted with 22 mothers who participated in the Mothers and Others: Family-based Obesity Prevention for Infants and Toddlers intervention trial. Interviews were audio-recorded and transcribed verbatim. A deductive and inductive process was used to develop a consensus codebook; once the data were coded, matrices were developed to explore the data and identify similarities and differences between respondents. Relevant themes were identified, and salient quotes were used to illustrate each theme. Mothers believed that time and taste were significant barriers to eating healthy. Social influence and social support had both positive and negative influences on mothers' ability to adopt healthy eating behaviours. Despite their children often being a facilitator to healthy eating, many mothers struggled with finding the time, energy and desire to focus on themselves when it came to healthy eating. Many mothers were intent on preparing healthy meals and snacks for their children but did not prepare them for themselves. Future interventions should focus on the importance of role-modelling healthy eating behaviours for their children and include behaviour change strategies that incorporate skill-building activities emphasizing time-saving methods for planning and preparing healthy meals and snacks for the whole family to eat.

Determinants of Tangible Breastfeeding Support Among Health Workers: A Multicenter Cross-Sectional Study.

BACKGROUND: Breastfeeding is crucial in providing infants with needed nutrition and immunity to foster their healthy growth and development; yet, optimal support from health workers is critical for it to be successful. AIM: To determine factors influencing tangible breastfeeding support among health workers in Nigeria. METHODS: This cross-sectional study was conducted in Nigeria's six geopolitical zones between August 2022 and February 2023 among health workers (N = 2,922). Data were gathered through an interviewer-administered, validated questionnaire. Significant factors of tangible breastfeeding support were identified through multivariable logistic regression, and corresponding odds ratios with 95% confidence intervals were reported. RESULTS: The mean age of the health workers was 28.6 (SD = 9.3) years. Just 45% (1,316) achieved optimal scores for tangible breastfeeding support. Only 31.4% (918) of lactation support providers/specialists practice tangible breastfeeding support and half (50.6%, 1,479) had a favorable attitude towards providing tangible breastfeeding support. About two-fifths (39.3%, 1,148) engaged caregivers in reviewing breast milk storage procedures, whereas, 54.6% (1,595) and 78.0% (2,279) of health workers assisted with breast pumps and breastfeeding attachment respectively. The odds of having optimal tangible breastfeeding support were higher for health workers aged 52 years or older compared to those aged under 20 years (aOR 1.88, 95% CI [1.13, 3.12]), a positive attitude (aOR 1.43, 95% CI [1.22, 1.69]), availability of a breastfeeding champion (aOR 1.47, 95% CI [1.21, 1.79]), 1.69]), provision of breast-pump videos (aOR; 2.33, 95% CI [1.85, 2.95]), and hand-expression videos (aOR; 1.41, 95% CI [1.02, 1.79]). (duplication). CONCLUSION: Health workers' tangible breastfeeding support in Nigeria is suboptimal and is driven by age, service level, attitude, availability of breastfeeding champions, and appropriate practice aids. Targeted interventions to improve health workers' attitudes, technical skills, provision of aids, and task shifting to non-specialists are needed for optimal tangible breastfeeding support.

Attitudes and Barriers of Polish Women towards Breastfeeding-Descriptive Cross-Sectional On-Line Survey.

BACKGROUND: Breastfeeding is the gold standard in infant nutrition. Successful breastfeeding depends on many factors, including the help of medical personnel in teaching breastfeeding, the need for professional work, and breastfeeding-friendly places in public spaces. The main goal was to identify various barriers among mothers to breastfeeding. METHODS: This study used a quantitative descriptive research design. We recruited 419 mothers aged at least 18 years old through social media. Results were analysed using Pearson's chi-squared and Fisher's tests of independence for pairs of dependent and independent variables. RESULTS: Most often, women gave birth at the age of 25-30, had one or two children, and attended higher education. Almost half of them lived in a large city and gave birth to a child by caesarean section. A total of 83.1% of mothers planned to breastfeed, but not all of them were able to do so for various reasons. One-third of them felt sorry for themselves that they had to change their feeding method. The majority of mothers did not receive sufficient help in the hospital in terms of learning how to breastfeed (61%), did not use the help of a lactation consultant (67%), and answered that there was no lactation consultant in their place of residence (65%). Only 43.2% of mothers returned to work without ceasing breastfeeding. A total of 42% of mothers experienced feelings of embarrassment when breastfeeding in a public place. The most frequently indicated barrier to breastfeeding in a public place was the lack of a suitable location where a woman would feel comfortable, calm, and intimate. CONCLUSION: There are various barriers towards breastfeeding: too few lactation consultants, problems with breastfeeding when the mother wants to return to work, and unfriendly places for breastfeeding in public spaces. Efforts must be made to support mothers in breastfeeding.

Parental Autonomy in the Care of Premature Newborns and the Experience of a Neonatal Team: Observational Prospective Study.

Background: The European Foundation for the Care of Newborn Infants (EFCNI) has promoted the importance of parental involvement in the care of children. Objective: The study aimed to examine how the time required by parents to achieve autonomy in the care of their very low-birth weight newborn infants was modified during the implementation of a training program. Methods: This was an observational prospective study in the context of a quality improvement initiative. The Cuídame (meaning "Take Care of Me" in English) program was aimed at achieving parental autonomy. It was implemented over 2 periods: period 1, from September 1, 2020, to June 15, 2021; and period 2, from July 15, 2021, to May 31, 2022. The days required by parents to achieve autonomy in several areas of care were collected from the electronic health system. Results: A total of 54 and 43 families with newborn infants were recruited in periods 1 and 2, respectively. Less time was required to acheive autonomy in period 2 for participation in clinical rounds (median 10.5, IQR 5-20 vs 7, IQR 4-10.5 d; P<.001), feeding (median 53.5, IQR 34-68 vs 44.5, IQR 37-62 d; P=.049), and observation of neurobehavior (median 18, IQR 9-33 vs 11, IQR 7-16 d; P=.049). More time was required to achieve autonomy for kangaroo mother care (median 14, IQR 7-23 vs 21, IQR 10-31 d; P=.02), diaper change (median 9.5, IQR 4-20 vs 14.5, IQR 9-32 d; P=.04), and infection prevention (median 1, IQR 1-2 vs 6, IQR 3-12; P<.001). Conclusions: Parents required less time to achieve autonomy for participation in clinical rounds, feeding, and observation of neurobehavior during the implementation of the training program. Nevertheless, they required more time to achieve autonomy for kangaroo mother care, diaper change, and infection prevention.

The effect of maternal concerns about childbirth and postpartum period on obsessive and compulsive behaviors related to baby care / Efecto de las preocupaciones maternas sobre el parto y el puerperio en las conductas obsesivas y compulsivas relacionadas con el cuidado del bebé

INTRODUCTION: Postpartum anxiety after childbirth is a common condition among pregnant women due to reasons such as the uncertainty of experiencing pregnancy and childbirth for the first time, or previous negative experiences. Fear of childbirth can affect the mother's baby care process. OBJECTIVE: This study was conducted analytically with a single-subject design to determine the effects of maternal concerns about childbirth and the postpartum period on obsessive and compulsive behaviors related to baby care. MATERIALS AND METHODS: The study was conducted with 260 mothers. Data were collected using a descriptive information form, and the scales 'Fear of Childbirth and Postpartum Period', and 'Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care'. The data were analyzed using the SPSS™ software to calculate percentages, mean values, t tests, ANOVA, Pearson's correlation, and simple linear regression analysis. RESULTS: A statistically significant and positive correlation was found between participant scores of the 'Fear of Childbirth and Postpartum Period' and the 'Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care' scales (p < 0.01). The regression model showed that 18.0% of the total variance in the obsessive and compulsive behaviors of mothers in the postpartum was explained by the fear of childbirth and the postpartum period (corrected R2 = 0.180). CONCLUSIONS: Fear of childbirth and the postpartum period were moderate. However, as the fear of women regarding childbirth and the postpartum period increased, their postpartum obsessive and compulsive behaviors about baby care also increased.

Introducción: La ansiedad del parto y el posparto es una condición común entre las mujeres embarazadas por la incertidumbre de vivir el embarazo y el parto por primera vez o por previas experiencias negativas. El miedo al parto puede afectar el proceso del cuidado del bebé de la madre. Objetivo: Determinar el efecto de las preocupaciones maternas sobre el parto y el puerperio y su efecto sobre las conductas obsesivas y compulsivas relacionadas con el cuidado del bebé. Materiales y métodos: El estudio se realizó con 260 madres. Los datos fueron recolectados en el formulario de información descriptiva y se usaron la "Escala de miedo al parto y al período posparto" y la de "Comportamientos obsesivos y compulsivos de las madres en el período posparto relacionados con el cuidado del bebé". Los datos fueron evaluados mediante el software SPSS™ mediante el cálculo de porcentajes, promedio, prueba t, ANOVA, correlación de Pearson y análisis de regresión múltiple. Resultados: Se encontró una correlación positiva y estadísticamente significativa entre la "Escala de miedo al parto y del período posparto" y la de "Comportamientos obsesivos y compulsivos de las madres en el período posparto relacionadas con el cuidado del bebé" (p < 0.01). En el modelo creado por análisis de regresión se observó que el 18,0% del cambio en la escala de comportamientos obsesivos-compulsivos estaba explicado por el miedo al parto y al puerperio (R2 corregido = 0,180). Conclusiones: En el estudio se determinó que el miedo al parto y al puerperio era moderado. Sin embargo, a medida que aumentaba el puntaje de miedo al parto y al período posparto, también aumentaban los comportamientos obsesivos y compulsivos de las madres en el puerperio relacionados con el cuidado del bebé.

Qualitative study with mothers of children with atopic dermatitis: emotional and social impacts.

INTRODUCTION: Atopic Dermatitis (AD) is the most common skin disease in childhood and its control requires the support of the family members. This disease significantly interferes with the Quality of Life (QoL) of children and families, however, literature on the social and emotional impact of the disease on the caregivers is lacking. OBJECTIVE: To evaluate the emotional and social impact of AD on mothers of children with the disease. METHOD: This is a qualitative study of semi-structured interviews with mothers of children diagnosed with AD. The following variables were evaluated: diagnosis and start of treatment, knowledge about the disease, and impact on the mothers' lives. The material was analyzed using Lawrence Bardin's content analysis technique. The AD severity was assessed by SCORAD. RESULTS: A total of 23 interviews were conducted with mothers of children diagnosed with AD. In 82.6% of the cases, the mothers presented conflicts in the face of the first contacts with the disease. In 43.5% of cases, mothers were solely responsible for their children's treatment. About 56.6% defined AD as a cause of suffering and difficulty and 21.7% pointed out the AD experience as a learning experience. CONCLUSION: The AD is a chronic disease that has a psychological and social impact on the lives of mothers. In the treatment of AD, mothers must be screened and offered psychological support to improve adherence to treatment in the long term.

Spatial variation and determinants of traditional birth attendants utilization among women of reproductive age in Ethiopia: Spatial and multilevel analysis study.

Background: Traditional birth attendant utilization has become a common malpractice and a leading cause of maternal morbidity and mortality in the developing world, such as Ethiopia. Therefore, this study was aimed at determining the geospatial variation and determinant factors of traditional birth attendant utilization among mothers of reproductive age in Ethiopia. Methods: The data were taken from the 2019 Ethiopian Demographic and Health Survey. Arc GIS, Excel, and STATA-14 software were used for the data analysis. The adjusted odds ratio with a 95% confidence interval was used to declare significant determinants of traditional birth attendance among mothers of reproductive age in Ethiopia. Results: Among 5,753 mothers of reproductive age, 34.59% of them utilized traditional birth attendants in Ethiopia during the 2019 Ethiopian Demographic and Health Survey. There was a geospatial variation of traditional birth attendants among mothers of reproductive age in Ethiopia; the Global Moran's index value was 0.39 with a p-value <0.001. The significant factors associated with traditional birth attendant utilization were the age of mothers; higher odds were observed among older mothers aged 35-49 years (AOR = 1.31; 95% CI (1.04-1.63)); educational level of mothers (AOR = 3.04; 95% CI (2.13-4.33)); higher odds were observed in uneducated mothers, wealth index (AOR = 2.76; 95% CI (1.83-4.19)); higher odds were observed among the poorer and poorest households, place of residence (AOR = 5.69; 95% CI (3.35-9.67)); and the regions; the highest odds were observed in Somali (AOR = 12.1; 95% CI (4.99-25.68)) and Afar (AOR = 7.13; 95% CI (2.37-21.38)). Conclusions: The utilization of traditional birth attendants among reproductive-age mothers became a major public health concern, and the distribution showed geo-spatial variations among the regions of the country. We recommend taking appropriate measures to alleviate the current problem by improving access to maternal healthcare services.

Systematic review and meta-analysis of the association between young maternal age and fetal abnormalities.

Fetal anomalies among young women and adolescents pose major public health concerns. This systematic review aims to elucidate the relationship between young maternal age and the incidence of fetal abnormalities. According to the systematic review and meta-analysis PRISMA protocol, cohort, cross-sectional and case-control studies were scrutinized to include 80,393,450 participants across diverse regions. The meta-analysis utilized Odds Ratios (OR) as the effect measure, adopting a random-effects model. The screening process involved 157 selected and verified manuscripts, which ultimately resulted in the final inclusion of 20 studied in the meta-analysis. The criterion for young maternal age was the age of ≤ 20 years. The meta-analysis revealed a pooled OR of 0.93 (95% CI: 0.82-1.05, p = 0.252), indicating no statistically significant association between young maternal age (≤ 20 years) and fetal anomalies. However, considerable heterogeneity (I² = 96.21%) was noted, prompting the use of a random-effects model to derive the reported results. The meta-analysis did not find statistically significant differences in the occurrence of congenital anomalies in fetuses of younger women than in overall population. Although due to significant heterogeneity of the analyzed studies, and a risk of bias, caution should be exercised when interpreting the results, further investigation may be warranted to understand the relationship between maternal age and risk of fetal anomalies. Nevertheless, the study shows significant differences, which diminish in collective analysis, suggests that factors beyond age may be influential. Specifically, the limited access to or quality of healthcare in certain regions could be a more critical factor than maternal age itself.

Oral feeding challenges of infants of diabetic mothers.

Objective: The presence of diabetes before or during pregnancy can increase perinatal mortality and morbidities. It is well known an infant of a diabetic mother (IDM) may experience complications such as macrosomia, hypoglycemia, respiratory distress syndrome, cardiac anomalies, and other abnormalities of organogenesis. Medical providers including physicians, nurses, and speech therapists have experienced challenges with helping IDMs orally feed. Challenges with oral feeding can lead to prolonged hospital stays and placement of supplemental feeding devices. The etiology of an IDM's oral feeding delays is not well understood and does not necessarily affect all infants. Study design: This descriptive review explores what is known about potential contributing factors to feeding difficulty in IDMs, including differences in infant behavior and swallowing mechanics. Results: Some IDMs are unable to maintain active alert states and have decreased autonomic regulation and motor control. Studies of sucking and swallowing demonstrate reduced sucking pressure, fewer sucking bursts, and slowing of esophageal sphincter function. Conclusion: The increasing prevalence of diabetes during pregnancy makes further investigations into the characteristics and trajectories of state, behavior, and oral feeding of IDMs imperative.

Exploring Intervention Frameworks to Improve Utilization of Elimination of Mother-to-Child Transmission Services in Africa: A Scoping Review.

BACKGROUND: Over the past two decades, intervention strategies to improve the use of the elimination of mother-to-child transmission (EMTCT) services have been implemented for several reasons. The reasons include elimination of HIV infections during pregnancy, delivery, breastfeeding, prevention of HIV, prevention of unintended pregnancies, and safer conception. Poor utilization of EMTCT services has been proven to put the child at risk of acquiring HIV, which could have been avoided. OBJECTIVE: This study aims to explore and describe interventions to promote the elimination of mother-to-child transmission services among pregnant and nursing mothers in Africa. METHOD: A scoping literature review technique was undertaken on research papers published in English that focused on EMTCT, barriers, interventions, and methods to address challenges to EMTCT utilization. These were screened independently and coded. RESULTS: The analysis comprised 14 out of approximately 9029 literature sources. Intervention strategies to improve EMTCT service utilization, according to the findings, include accessibility and affordability, healthcare worker training, integrating the elimination of mother-to-child transmission into maternal and child health services, community-based interventions, family-centred approaches, and the use of technology. CONCLUSIONS: Interventions that increase women's use of EMTCT services will contribute to the aim of HIV-free generation by reducing new HIV infections in children and saving lives.