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1.
MMWR Morb Mortal Wkly Rep ; 69(39): 1385-1390, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33001877

RESUMO

Homicide is the 13th leading cause of death among infants (i.e., children aged <1 year) in the United States (1). Infant homicides occurring within the first 24 hours of life (i.e., neonaticide) are primarily perpetrated by the mother, who might be of young age, unmarried, have lower educational attainment, and is most likely associated with concealment of an unintended pregnancy and nonhospital birthing (2). After the first day of life, infant homicides might be associated with other factors (e.g., child abuse and neglect or caregiver frustration) (2). A 2002 study of the age variation in homicide risk in U.S. infants during 1989-1998 found that the overall infant homicide rate was 8.3 per 100,000 person-years, and on the first day of life was 222.2 per 100,000 person-years, a homicide rate at least 10 times greater than that for any other time of life (3). Because of this period of heightened risk, by 2008 all 50 states* and Puerto Rico had enacted Safe Haven Laws. These laws allow a parent† to legally surrender an infant who might otherwise be abandoned or endangered (4). CDC analyzed infant homicides in the United States during 2008-2017 to determine whether rates changed after nationwide implementation of Safe Haven Laws, and to examine the association between infant homicide rates and state-specific Safe Haven age limits. During 2008-2017, the overall infant homicide rate was 7.2 per 100,000 person-years, and on the first day of life was 74.0 per 100,000 person-years, representing a 66.7% decrease from 1989-1998. However, the homicide rate on first day of life was still 5.4 times higher than that for any other time in life. No obvious association was found between infant homicide rates and Safe Haven age limits. States are encouraged to evaluate the effectiveness of their Safe Haven Laws and other prevention strategies to ensure they are achieving the intended benefits of preventing infant homicides. Programs and policies that strengthen economic supports, provide affordable childcare, and enhance and improve skills for young parents might contribute to the prevention of infant homicides.


Assuntos
Maus-Tratos Infantis/legislação & jurisprudência , Criança Abandonada/legislação & jurisprudência , Homicídio/estatística & dados numéricos , Adulto , Feminino , Homicídio/prevenção & controle , Humanos , Lactente , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
2.
Rev Lat Am Enfermagem ; 28: e3364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027402

RESUMO

OBJECTIVE: to analyze the relationship between maternal self-efficacy to breastfeed and sociodemographic, obstetric, and neonatal variables; between the duration of exclusive breastfeeding and sociodemographic variables; and between the breastfeeding self-efficacy and the duration of exclusive breastfeeding at the intervals of 30, 60, and 180 days postpartum. METHOD: a longitudinal and prospective study conducted with 224 women. A sociodemographic questionnaire, the Breastfeeding Self-Efficacy Scale - Short Form, and a questionnaire on breastfeeding and child feeding were used for collecting the data. Fisher's exact test and Pearson's correlation coefficient test were used for analysis. RESULTS: there was no association between breastfeeding self-efficacy and the duration of exclusive breastfeeding identified at 30, 60, and 180 days. Self-efficacy was associated with the type of delivery and complications in the postpartum period. There was also an association between religion and exclusive breastfeeding 30 and 60 days postpartum, and assistance with baby care and exclusive breastfeeding at 60 days. CONCLUSION: It was identified that the type of delivery, complications in the postpartum period, religion, and assistance with baby care corroborate to increase maternal confidence in the ability to breastfeed.


Assuntos
Aleitamento Materno , Autoeficácia , Adulto , Criança , Feminino , Humanos , Mães , Período Pós-Parto , Gravidez , Estudos Prospectivos
3.
Artigo em Inglês | MEDLINE | ID: mdl-33036326

RESUMO

Physical activity is known to decline during pregnancy and the postnatal period, yet physical activity is recommended during this time due to the significant health benefits for mothers and their offspring. As a result of the COVID-19 pandemic and the restrictions imposed to reduce infection rates, pregnant and postnatal women have experienced disruption not just to their daily lives but also to their pregnancy healthcare experience and their motherhood journey with their new infant. This has included substantial changes in how, when and why they have engaged with physical activity. While some of these changes undoubtedly increased the challenge of being sufficiently active as a pregnant or postnatal woman, they have also revealed new opportunities to reach and support women and their families. This commentary details these challenges and opportunities, and highlights how researchers and practitioners can, and arguably must, harness these short-term changes for long-term benefit. This includes a call for a fresh focus on how we can engage and support those individuals and groups who are both hardest hit by COVID-19 and have previously been under-represented and under-served by antenatal and postnatal physical activity research and interventions.


Assuntos
Infecções por Coronavirus/psicologia , Exercício Físico , Mães/psicologia , Pandemias , Pneumonia Viral/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Promoção da Saúde , Humanos , Lactente , Motivação , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Cuidado Pós-Natal , Gravidez , Complicações Infecciosas na Gravidez/psicologia
5.
Z Psychosom Med Psychother ; 66(3): 243-258, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32876552

RESUMO

Objectives: Addressing the lack of population-based data, the purpose of this representative study was to assess sex- and age-specific associations of maternal and paternal rearing behavior with depressiveness and anxiety controlling for sociodemographic and somatic variables. Methods: 8,175 subjects participating in a population-based study completed standardized questionnaires measuring Recalled Parental Rearing Behavior and distress. Results: Women recalled their fathers as more controlling and warmer, and their mothers as more rejecting than men. Comparisons between age groups (≤ 60 vs. > 60 years) revealed that younger participants recalled more parental control and emotional warmth. In addition to sociodemographic and somatic risk factors, paternal rejection and maternal control were associated with depressiveness and anxiety both for women and men (OR 1.58-1.96; OR 1.37-1.66). Maternal warmth was negatively related to distress (OR 0.66-0.69). Conclusions: Findings suggested sex- and age-specific differences in recalled maternal and paternal rearing behavior. The current results highlighted the important role of recalled parental rearing behavior besides sociodemographic factors and somatic diseases for the occurrence of depression and anxiety symptoms across the age groups.


Assuntos
Ansiedade/psicologia , Educação Infantil , Depressão/psicologia , Rememoração Mental , Mães/psicologia , Inquéritos e Questionários , Adulto , Fatores Etários , Transtornos de Ansiedade/psicologia , Criança , Transtorno Depressivo/psicologia , Pai/psicologia , Feminino , Humanos , Masculino , Características de Residência , Fatores Sexuais
6.
Psychiatr Danub ; 32(Suppl 1): 24-28, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890357

RESUMO

BACKGROUND: Infanticide is not a new concept. It is often confused with child murder, neonaticide, filicide or even genderside. Each of these concepts has to be defined clearly in order to be understood. Through time reasons for infanticide have evolved depending on multiple factors such as culture, religion, beliefs system, or attempts to control the population. It was once seen as a moral virtue. So what has changed? SUBJECTS AND METHODS: Between January 2020 and May 2020, a literature search based on electronic bibliographic databases as well as other sources of information (grey literature) was conducted in order to investigate the most recent data on infanticide and child murder, especially the newest socio-economic and psychiatric considerations as well as the different reasons why a mother or a father ends up killing their own child and the Irish situation. RESULTS: Recent works on the subject demonstrate how some new socio economic factors and family considerations impact on infanticide. Mental illness, especially depression and psychosis, is often part of the picture and represent a very high risk factor to commit infanticide and filicide. Fathers and mothers do not proceed the same way nor for the same reasons when they kill their offspring. Neonaticide and infanticide are almost always committed by women. A recent case in Ireland (2020) proves how filicide remains an actual problem. CONCLUSIONS: Filicide is a relatively rare event, and therefore particularly impact both the public and the press when it occurs. Infanticide does not result from a unique cause, but from multiple factors (some being well known, some remaining hypothetical). Psychopathological and socio-economical parameters associated to peculiar family grounds are currently prevalent. To help and prevent infanticide, screening for psychiatric disorders and risk factors and treating or offering assistance to parents at risk should be implemented.


Assuntos
Homicídio , Infanticídio , Criança , Pai , Feminino , Humanos , Lactente , Irlanda , Masculino , Mães
7.
Eur J Paediatr Dent ; 21(3): 192-196, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893650

RESUMO

AIM: To identify factors associated with negative child behaviour in the dental setting. MATERIALS AND METHODS: A cross-sectional study was conducted with a sample of 324 mother-child pairs (children aged 3 to 12 years) seen at a university clinic in Canoas, southern Brazil. Mother's anxiety was measured using the Beck Anxiety Inventory. Oral examinations were performed to determine caries experience (dmft/DMFT index) in the mothers and children. Child behaviour was evaluated at six moments of the dental visit using the Frankl scale. Statistical analysis involved Poisson regression with robust variance. RESULTS: The prevalence of negative child behaviour was 9.3%, with a greater frequency among younger children, those with no previous use of dental services and those whose mothers exhibited a moderate to severe level of anxiety. The multivariable analysis demonstrated that the probability of negative behaviour was 2.4-fold greater among children who had not previous dental services attendance (PR = 2.37, 95% CI:1.13-4.95; p=0.022) and 3.1-fold greater among those whose mothers had a moderate to severe level of anxiety (PR = 3.08, 95% CI:1.64-5.75; p<0.001). CONCLUSION: Mother's anxiety, younger age and no previous history of visiting a dentist are associated with negative behaviour during a dental appointment and therefore merit special attention.


Assuntos
Cárie Dentária , Brasil , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Mães , Prevalência , Fatores Socioeconômicos
8.
Oral Health Prev Dent ; 18(1): 741-746, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32895657

RESUMO

PURPOSE: To verify the prevalence of developmental defects of enamel (DDE) in deciduous teeth and analyse the association with adverse events that occurred during pregnancy and early childhood. MATERIALS AND METHODS: In a cross-sectional study, 152 children with an average age of 3.57 ± 1.25 years were examined according to the criteria established by the DDE index. A previously validated questionnaire was given to mothers in order to obtain information regarding: calcium and vitamin D deficiency (measured in mothers); gestational diabetes; gestational undernutrition; weight at birth; neonatal hypoxia; and presence of asthma in early childhood. The clinical exam was conducted by a single examiner calibrated for visual exams (Kappa = 0.84), outdoors on patios of schools with children and examiner knee to knee. Pearson's chi-squared test and Fisher's Exact Test (p < 0.05) were used to determine statistically significant associations between the variables in study. The data were then analysed using a binary logistic regression regression. RESULTS: 26.3% of children exhibited DDE. It was possible to verify a statistically significant association between DDE and vitamin D deficiency (p < 0.01), calcium deficiency (p = 0.01), neonatal hypoxia (p = 0.026), and gestational diabetes (p = 0.04). The regression model allowed the conclusion that children who had neonatal hypoxia during childbirth, gestational diabetes or vitamin D deficiency during their gestation were 3.54, 12.47 and 6.40 more likely to exhibit signs of DDE, respectively. CONCLUSION: The prevalence of DDE was considered high and was associated with vitamin D and calcium deficiency during pregnancy, gestational diabetes, and neonatal hypoxia.


Assuntos
Hipoplasia do Esmalte Dentário , Criança , Pré-Escolar , Estudos Transversais , Esmalte Dentário , Feminino , Humanos , Mães , Gravidez , Prevalência , Dente Decíduo
9.
J Pregnancy ; 2020: 2097285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32908703

RESUMO

Introduction: Practicing exclusive breastfeeding (EBF) in an infant's first six months of life is recommended by the World Health Organization because of its proven effectiveness as a method to support the infant's short- and long-term physical and cognitive development. However, many countries, including Cambodia, face contextually driven challenges in meeting this optimum standard of breastfeeding. The recent declining EBF rate in Cambodia is a concerning indicator of the impact of these challenges. Methods: We used existing data from the 2014 Cambodian Demographic and Health Survey (CDHS) to analyze 717 Cambodian mother-infant pairs. CDHS 2014 used a two-stage stratified cluster sampling approach to select samples. A multivariable logistic regression analysis was used to assess determinants of EBF, taking into account the sampling weight in the analysis. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and significance level was considered at p value < 0.05. Results: Our findings indicate that among mothers with infants under six months, EBF was more likely if they resided rurally (AOR = 2.28; 95% CI 1.23-4.23) and if they delivered at a public hospital (AOR = 2.64; 95% CI 1.28-5.47). On the other hand, mothers of middle wealth index practiced EBF less than mothers of low wealth index (AOR = 0.58; 95% CI 0.34-0.99). And as expected, our analysis confirmed that the older the infants grew, the less likely they were to be exclusively breastfed than those younger than one month old (2-3 months: AOR = 0.49; 95% CI 0.26-0.92; 4-5 months: AOR = 0.25; 95% CI 0.15-0.43). Conclusion: The findings emphasize the need to address these determinants adequately by appropriate interventions to halt the declining trend of EBF practice. We recommend a multifaceted approach to improve EBF rates in Cambodia. Advocacy around EBF at public hospitals should continue, and private hospital staff should receive training to provide EBF counselling and support to mothers.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Aleitamento Materno/tendências , Mães/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Camboja/epidemiologia , Aconselhamento , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , População Rural , Classe Social , Apoio Social , Adulto Jovem
10.
Int Heart J ; 61(5): 1049-1055, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32921676

RESUMO

While a KCND3 V392I mutation uniquely displays a mixed electrophysiological phenotype of Kv4.3, only limited clinical information on the mutation carriers is available. We report two teenage siblings exhibiting both cardiac (early repolarization syndrome and paroxysmal atrial fibrillation) and cerebral phenotypes (epilepsy and intellectual disability), in whom we identified the KCND3 V392I mutation. We propose a link between the KCND3 mutation with a mixed electrophysiological phenotype and cardiocerebral phenotypes, which may be defined as a novel cardiocerebral channelopathy.


Assuntos
Fibrilação Atrial/genética , Canalopatias/genética , Epilepsias Parciais/genética , Deficiência Intelectual/genética , Canais de Potássio Shal/genética , Adolescente , Morte Súbita Cardíaca , Eletrocardiografia , Eletroencefalografia , Feminino , Humanos , Pessoa de Meia-Idade , Mães , Mutação , Linhagem , Irmãos , Síncope/genética , Adulto Jovem
11.
BMC Infect Dis ; 20(1): 666, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912140

RESUMO

BACKGROUND: Neonatal sepsis is one of the major causes of death during the first month of life and early empirical treatment with injectable antibiotics is a life-saving intervention. Adherence to World Health Organisation guidelines on first line antibiotics is crucial to mitigate the risks of increased antimicrobial resistance. The aim of this paper was to evaluate if treatment of early onset neonatal sepsis in a low-income facility setting observe current guidelines and if compliance is influenced by contextual factors. METHODS: This cohort study used data on antimicrobial treatment of neonatal sepsis onset within 72 h of life from 12 regional hospitals participating in a scale-up trial of a neonatal resuscitation quality improvement package intervention in Nepal. Infants treated according to guidelines were compared with those receiving other antimicrobials. A multiple logistic regression analysis adjusted for the intervention and time trend was applied. RESULTS: 1564 infants with a preliminary diagnosis of early onset sepsis were included. A majority (74.9%) were treated according to guidelines and adherence was increasing over time. Infants born at larger facilities (adjusted Odds Ratio 5.6), those that were inborn (adjusted Odds Ratio 1.97) or belonging to a family of dis-advantaged caste (adjusted Odds Ratio 2.15) had higher odds for treatment according to guidelines. A clinical presentation of lethargy or tachypnoea was associated with adherence to guidelines. CONCLUSION: Adherence to guidelines for antibiotic treatment of early neonatal sepsis was moderately high in this low-income setting. Odds for observing guidelines increased with facility size, for inborn infants and if the family belonged to a dis-advantaged caste. Cefotaxime was a common alternative choice when guidelines were not followed, highly relevant for the risk of increased antimicrobial resistance. TRIAL REGISTRATION: ISRCTN, ISRCTN30829654 , registered 17th of May, 2017.


Assuntos
Antibacterianos/uso terapêutico , Fidelidade a Diretrizes , Sepse Neonatal/tratamento farmacológico , Pobreza , Guias de Prática Clínica como Assunto , Adulto , Estudos de Coortes , Feminino , Hospitais , Humanos , Recém-Nascido , Mães , Sepse Neonatal/diagnóstico , Nepal , Parto , Gravidez , Ressuscitação , Fatores Socioeconômicos , Resultado do Tratamento , Organização Mundial da Saúde , Adulto Jovem
12.
N Engl J Med ; 383(13): 1204-1205, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32966721
13.
Nonlinear Dynamics Psychol Life Sci ; 24(4): 431-449, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32960756

RESUMO

This paper aimed to (a) validate a novel technique that quantifies the length of the trajectories the cardiac system follows within a two-dimensional state-space, and (b) test its usefulness to better understand how cognitive emotion regulation (CER) style is associated with cardiac output. A positive CER style was assessed in a sample of healthy adolescents (n = 57), and mean and total distances, in addition to heart rate variability (HRV) measures and cardiac entropy (SampEn), were calculated during a conflict discussion with the adolescents' mothers. Associations between distances and HRV measures in time and frequency-domains and SampEn were examined to better understand the physiological meaning of distances; further, whether a positive CER style would predict distances, HRV, and SampEn. Correlation analysis revealed that associations of distances with time-domain HRV measures were stronger than associations with frequency-domain HRV measures, while correlations between distances and SampEn were moderate. Hierarchical multiple regression analysis revealed that a positive CER style predicted distances and SampEn, but not HRV measures. Distances are clearly time-domain measures of HRV, but only partly capture the complexity of the heart signal. The results highlight the importance of assessing heart rate dynamics beyond HRV in the study of CER.


Assuntos
Regulação Emocional , Conflito Familiar , Frequência Cardíaca , Relações Mãe-Filho , Mães , Adolescente , Adulto , Cognição , Feminino , Coração , Humanos
14.
Georgian Med News ; (304-305): 135-141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965264

RESUMO

The purpose of this scientific work was to investigate the development of puberty in females-offspring born to mothers of different age with fetoplacental insufficiency (FPI) and to evaluate efficacy of base and combined drug therapy during pregnancy. Negative influence of FPI on the puberty genesis of females-offspring born to mothers of different reproductive age is considered to be the results of the investigation. In particular, the increased anogenital distance, which is the sign of estrogen deficiency, has been observed in females-offspring born to reproductively young mothers with FPI. Females-offspring born to reproductively matured mothers with FPI have demonstrated more negative changes of reproductive system development. That is, body mass and anogenital distance increasing amid accelerated sexual development have been detected. The increasing of testosterone level has caused inadequate ovaries stimulation which has led to steroid genesis disturbances. During histological investigation of ovarian structure of pubertal rats born to mothers of both groups of age, the decreasing of follicles density, the disturbance in follicles types ratio - early secondary follicles were prevailed, declining folliculogenesis reserve and increased number of atretical follicles have been observed. The introduction of pharmaceutical composition to pregnant rats of both groups of age amid fetoplacental insufficiency leads to stronger normalization of reproductive system development in females-offspring than using of drug of comparison.


Assuntos
Mães , Maturidade Sexual , Feminino , Humanos , Ovário , Parto , Gravidez , Reprodução
15.
Medicine (Baltimore) ; 99(36): e22061, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899072

RESUMO

INTRODUCTION: Nilotinib is a selective inhibitor of the BCR-ABL tyrosine kinase receptor and is used in the management of chronic myelogenous leukemia (CML). Nilotinib therapy at high doses is associated with elevated serum bilirubin levels. If the serum bilirubin level exceeds 3 times the upper limit of normal, the recommendation is to either adjust nilotinib dosage or temporarily discontinue the treatment. However, it is unclear whether hyperbilirubinemia indicates obvious liver histology damage. PATIENT CONCERNS: A 24-year-old man with confirmed CML was treated with nilotinib therapy and developed hyperbilirubinemia after the treatment. Although the first remission of the hyperbilirubinemia was achieved after dose adjustment, the hematological parameters deteriorated. Thus, we initiated an antineoplastic therapy (at the standard dose) until complete remission of the CML was achieved. The pathogenic mechanism of hyperbilirubinemia may be related to the inhibition of uridine diphosphate-glucuronosyltransferase (UGT1A1) activity. Liver histological analysis revealed no significant liver damage. In addition, the patient had no family history of hyperbilirubinemia and liver disease. DIAGNOSIS: The patient was admitted to our hospital under the diagnosis of hyperbilirubinemia, and histopathology by liver biopsy showed no obvious damage. We also detected a UGT1A1 mutation [ex1 c.686C > A (p.Pro229Gln)] in the patient and his mother. INTERVENTIONS: When the nilotinib dose was decreased to 300 mg daily, the total bilirubin (TBIL) level decreased to 30 to 50 µmol/L for 1 month. However, because the Bcr-Abl/Abl ratio did not correspond to the major molecular response (MMR; <0.1%), the nilotinib dose was readjusted to 400 mg daily. One week later, the TBIL and indirect bilirubin levels increased to 89 and 79 µmol/L, respectively. The levels of alanine transaminase and other liver functional indicators were normal. OUTCOMES: A Naranjo Adverse Drug Reaction (ADR) Probability Scale score of 13 indicates that hyperbilirubinemia is attributed to ADR caused by nilotinib rather than by drug-induced liver injury. CONCLUSION: Although reducing the nilotinib dose can alleviate the occurrence of hyperbilirubinemia, the effect of MMR is also reduced. Treatment of CML without dose adjustment or discontinuation of nilotinib therapy may be more advantageous.


Assuntos
Doença Hepática Crônica Induzida por Substâncias e Drogas/diagnóstico , Proteínas de Fusão bcr-abl/antagonistas & inibidores , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Inibidores de Proteínas Quinases/efeitos adversos , Pirimidinas/efeitos adversos , Idoso , Antineoplásicos/uso terapêutico , Doença Hepática Crônica Induzida por Substâncias e Drogas/patologia , China/epidemiologia , Feminino , Glucuronosiltransferase/efeitos dos fármacos , Glucuronosiltransferase/genética , Humanos , Hiperbilirrubinemia/induzido quimicamente , Japão/epidemiologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mães , Mutação , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/uso terapêutico , Indução de Remissão , Adulto Jovem
16.
Medicine (Baltimore) ; 99(37): e22147, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925771

RESUMO

Health disorders in mothers and their children are subject to mutual influences arising from the nature of mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in aspect of growth hormone (GH) therapy in Poland.The study was based on a group of 101 mothers of originally short-stature children: 70 with GH deficiency treated with recombinant human GH and 31 undergoing the diagnostic process, without any treatment. Collected medical data included the child's gender, height and weight, chronological age, bone age delay, and GH therapy duration. For all children the height SDS (standard deviation score of height) and BMI SDS (standard deviation score of body mass index) were calculated. The Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels among the recruited mothers. Obtained results revealed low trait anxiety levels in all mothers, with no statistically significant differences between the groups. State anxiety levels were significantly higher in mothers of children without diagnosis and treatment than in mothers of children receiving appropriate therapy. Significantly lower levels of maternal state anxiety were observed during the first stage of the GH therapy, and they were further reduced in mothers of children treated for more than 4 years.Growth failure in Polish children is not associated with high maternal anxiety as a personality trait, but lack of diagnosis and lack of appropriate treatment seem to generate high levels of anxiety as a transient state in mothers. The initiation of GH therapy induces a substantial reduction of maternal state anxiety, and the duration of this treatment causes its further decrease. Mothers of short children undergoing diagnostic process could benefit from psychological support, but it seems to be unnecessary when their children are treated with GH.


Assuntos
Ansiedade/epidemiologia , Transtornos do Crescimento/psicologia , Hormônio do Crescimento/deficiência , Hormônio do Crescimento Humano/uso terapêutico , Mães/psicologia , Adolescente , Fatores Etários , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Feminino , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/tratamento farmacológico , Humanos , Masculino , Polônia/epidemiologia , Fatores Sexuais
17.
Int Breastfeed J ; 15(1): 82, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928250

RESUMO

BACKGROUND: The COVID-19 pandemic is disrupting normal life globally, every area of life is touched. The pandemic demands quick action and as new information emerges, reliable synthesises and guidelines for care are urgently needed. Breastfeeding protects mother and child; its health benefits are undisputed and based on evidence. To plan and support breastfeeding within the current pandemic, two areas need to be understood: 1) the clinical characteristics of COVID-19 as it applies to breastfeeding and 2) the protective properties of breastfeeding, including the practice of skin-to-skin care. This review aims to summarise how to manage breastfeeding during COVID-19. The summary was used to create guidelines for healthcare professionals and mothers. METHODS: Current publications on breastfeeding during the COVID-19 pandemic were reviewed to inform guidelines for clinical practice. RESULTS: Current evidence states that the Coronavirus is not transmitted via breastmilk. Breastfeeding benefits outweigh possible risks during the COVID-19 pandemic and may even protect the infant and mother. General infection control measures should be in place and adhered to very strictly. CONCLUSIONS: Breastfeeding should be encouraged, mothers and infant dyads should be cared for together, and skin-to-skin contact ensured throughout the COVID-19 pandemic. If mothers are too ill to breastfeed, they should still be supported to express their milk, and the infant should be fed by a healthy individual. Guidelines, based on this current evidence, were produced and can be distributed to health care facilities where accessible information is needed.


Assuntos
Aleitamento Materno , Infecções por Coronavirus/fisiopatologia , Pneumonia Viral/fisiopatologia , Betacoronavirus/fisiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Leite Humano/química , Mães/estatística & dados numéricos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
18.
J Pregnancy ; 2020: 7019676, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32953177

RESUMO

Background: Ethiopia still suffers high levels of neonatal and maternal mortality, so the maternity continuum of care is a continuous framework for the delivery of maternal care from pregnancy to the postnatal period. Skilled care during pregnancy, childbirth, and the postpartum period is an important intervention in reducing maternal and neonatal morbidity and mortality. But in Ethiopia, there are limited studies on the completion of the maternity continuum of care, so this study will help to suggest interventions in order to reduce the dropout of the maternity continuum of care. Objective: To assess the completion of the maternity continuum of care and factors associated with it among mothers who gave birth in the last one year in Enemay District, Northwest Ethiopia. Method and Materials. A community-based cross-sectional study was conducted from February 25 to March 10, 2019, on 651 women who gave birth in the last one year. The data were collected by a face-to-face interview through pretested and structured questionnaires. Binary logistic regression was used to identify predictors of the completion of the maternity continuum of care. Variables with a P value < 0.05 in multivariable analysis were declared as statistically significant associated factors. Results: This study revealed that about 45% (95% CI: 40.9%, 48.8%) of respondents completed the continuum of care. Women with secondary education (AOR = 6, 95% CI: 2.26, 16.6), women whose occupation is farming (AOR = 0.18, 95%, CI: 0.1, 0.32), women who have autonomy in health care decision (AOR = 4, 95% CI: 2.26, 7.2), women who have exposure to media (AOR = 1.97, 95% CI: 1.2, 3.27), women with wanted pregnancies (AOR = 3.33, 95% CI: 1.87, 5.9), para five and above women (AOR = 2.85, 95% CI: 1.28, 6.3), and women whose husbands are employed (AOR = 4.97, 95% CI: 1.16, 21.2) were significantly associated with the completion of the maternity continuum of care. Conclusions and Recommendation. This study showed that less than half of the participants had achieved the continuum of care and education level, and both respondents and their husband's occupation, parity, autonomy in health care decision, exposure to the mass media, and wantedness of pregnancy were associated with the completion of the maternity continuum of care; therefore, working on enhancing the capacity of women's autonomy in health care and decision-making and preventing unintended pregnancy helps to improve the completion of the maternity continuum of care.


Assuntos
Assistência à Saúde , Serviços de Saúde Materna/estatística & dados numéricos , Mães , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Tomada de Decisões , Escolaridade , Etiópia/epidemiologia , Feminino , Humanos , Meios de Comunicação de Massa , Autonomia Pessoal , Gravidez , Gravidez não Planejada , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
19.
J Pregnancy ; 2020: 8395142, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32953178

RESUMO

Background: Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration. However, episiotomy should be done with judicious indication to lower perineal laceration with fewer complications. Despite its adverse effects, the magnitude of episiotomy is increasing due to different factors. Therefore, this study is aimed at determining the recent magnitude of episiotomy and at identifying associated factors among women who gave delivery in Arba Minch General Hospital, Southern Ethiopia. Methods: An institution-based cross-sectional study was conducted from December 15, 2018, to January 30, 2019. A systematic random sampling technique was used to select study participants. A semistructured questionnaire was used to collect data. This was supplemented with a review of the labor and delivery records. Binary and multivariable logistic regression analyses were performed to identify factors associated with the magnitude of episiotomy. P value ≤ 0.05 was used to determine the level of statistically significant variables. Results: The magnitude of episiotomy was found to be 272 (68.0%) with 95%CI = 64.0-72.5. Women who attended secondary education [AOR = 10.24, 95%CI = 2.81-37.34], women who attended college and above [AOR = 4.61, 95%CI = 1.27-16.71], birth weight ≥ 3000 g [AOR = 4.84, 95%CI = 2.66-8.82], primipara [AOR = 4.13, 95%CI = 2.40-7.12], being housewife occupants [AOR = 3.43, 95%CI = 1.20-9.98], married women [AOR = 2.86, 95%CI = 1.40-5.84], and body mass index < 25 kg/m2 [AOR = 2.85, 95%CI = 1.50-5.44] were independent variables found to have significant association with episiotomy. Conclusion: The magnitude of episiotomy was 68.0% which is higher than the recommended practice by WHO (10%). The study participants' occupational status, marital status, educational status, parity, birth weight, and BMI were significantly associated with the magnitude of episiotomy in the study area. Therefore, to reduce the rate of episiotomy, it is better to have periodic training for birth attendants regarding the indication of episiotomy.


Assuntos
Episiotomia/estatística & dados numéricos , Hospitais Gerais/estatística & dados numéricos , Trabalho de Parto , Lacerações/prevenção & controle , Mães/estatística & dados numéricos , Adolescente , Adulto , Peso ao Nascer , Índice de Massa Corporal , Estudos Transversais , Escolaridade , Episiotomia/efeitos adversos , Etiópia/epidemiologia , Feminino , Humanos , Ocupações , Paridade , Gravidez , Risco , Cônjuges , Inquéritos e Questionários , Adulto Jovem
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