Birth order moderates the association between adverse childhood experiences and externalizing behavior symptoms in adolescence.

Adverse childhood experiences (ACEs) are associated with externalizing behaviors. Whereas some ACEs affect individual children (i.e., child-specific; e.g., failing a grade), others affect the family unit (i.e., family-wide; e.g., parent losing a job); effects of ACEs on externalizing behavior may manifest differently across groupings of ACEs. Moreover, birth order may modify the association between child-specific and family-wide ACEs and externalizing behavior due to differences in the experience of being a younger versus older sibling. This study examined the externalizing behavior of siblings in relation to their experiences of child-specific and family-wide ACEs to test the hypothesis that younger siblings are at greater risk for developing externalizing symptoms following familial ACE exposure. Participants were 61 sibling pairs (younger sibling Mage = 11.37 years, 44.1% male; older sibling Mage = 13.1 years, 52.5% male) recruited from six schools in the northeastern United States. Parents rated each child's externalizing behaviors (e.g., bullying, meanness) and retrospectively reported on each child's experience of 34 ACEs; two raters categorized ACEs as child-specific (n = 10) or family-wide (n = 24). Multilevel modeling revealed that both child-specific and family-wide ACEs were associated with increased externalizing behaviors. Birth order moderated the effect of family-wide (but not child-specific) ACEs on externalizing behaviors, independent of sex and age. Externalizing behavior was higher for younger siblings as compared with older siblings, particularly when a high number of ACEs (6+) were reported. This research should prompt future exploration of mechanistic theories of the impact of family-wide and child-specific ACEs and the role of birth order.

The Interplay of Cesarean-Section Delivery and First-Birth Order as Risk Factors in Acute Lymphoblastic Leukemia.

BACKGROUND: Childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has been associated with early-life exposures, including birth by cesarean section (C-section), and a deficit of social exposure (first child). These exposures as proxies for microbiome acquisition in infancy are essential to prime the immune system and restrain later dysregulated immune responses that can trigger ALL in susceptible individuals. We tested risk factors pertaining to immune stimulation that may impact BCP-ALL development. METHODS: Cases comprised 1,126 children (0-12 years) with ALL (BCP-ALL: 78.5%) from the EMiLI study group in Brazil (2002-2020). Age- and sex-matched controls (n = 2,252) were randomly selected from healthy children whose mothers participated in the National Placental and Umbilical Cord Blood Bank donation. Multiple logistic regression was run fitted and adjusted for selected covariates models. RESULTS: C-section delivery was associated with increased risk for ALL [odds ratio (OR) ALL: 1.10; 95% confidence intervals (CI), 1.04-1.15; ORBCP-ALL: 1.09; 95% CI, 1.03-1.14], as well as being the firstborn child. Interaction analysis showed a significant effect of first birth on the observed C-section associations (P < 0.0001). Indeed, high-risk children, namely, firstborn children delivered via C-section were at increased risk for ALL (OR: 2.33; 95% CI, 2.40-4.84) compared with non-first, vaginally born children. An increased risk was found for firstborn children delivered by C-section and non-breastfed with ALL (ORALL: 2.32; 95% CI, 1.27-4.24; ORBCP-ALL: 2.37; 95% CI, 1.18-4.76). CONCLUSIONS: Our observations are in accord with the prediction that exposures determining microbiome composition and adrenal pathway in infancy contribute to the risk of BCP-ALL. IMPACT: These findings encourage the exploration of potential preventive interventions. See related commentary by Wiemels and Gallant, p. 292.

Birth order, stimulating environment, and maternal factors in developmental outcomes: A longitudinal Mexican study.

This study longitudinally examined the interplay between birth-order and well-known risk factors in impoverished environments such as inadequate environmental stimulation, low maternal education, and young maternal age in children from birth to 36 months. In the developmental motor domain, the effect of the stimulating environment over time, favored first-borns. In the adaptive domain, maternal education privileged first-born boys. In language development, first-borns reached higher scores over time than laterborn identifying a positive impact of stimulation. In the personal-social domain, firstborns obtained higher averages overall, but stratified models revealed that later-borns reached the first-borns scores as maternal age increased.

Dietary intake of protein sources in infants between 7-24 months old: Start time and compliance with recommendations. / Ingesta alimentaria de fuentes proteicas en lactantes entre 7-24 meses: Tiempo de inicio y cumplimiento de recomendaciones.

INTRODUCTION: Adequate nutrition includes breastfeeding, infant formula, and the incorporation of complementary feeding (CF). OBJECTIVE: To describe compliance with the recommendations for protein intake from CF in healthy infants between 7 and 24 months old. PATIENTS AND METHOD: Healthy infants from an outpatient center were studied. To collect the variables under study, we designed and applied a questionnaire. We obtained demographic data, breastfeeding, use of formula, and incorporation and compliance with protein intake data. The analysis of variables was carried out with STATA software version 13, and the Chi-square test and one-way ANOVA were applied. RESULTS: 85 infants were stu died, 54% were female, 68% of infants were exclusively breastfed until 6 months old, and 84.7% star ted complementary feeding at that age. 37.6% complied with the incorporation of fish, 49.4% with legumes, and 45.8% with egg. 52% of infants aged between 10 and 12 months and 83% of infants bet ween 13 and 24 months consumed more beef, chicken, or turkey. This data was associated with being the first child and older age, as well as egg consumption where infants older than 12 months ate more than recommended. We observed lower than recommended fish consumption in 78% of infants aged between 10 and 12 months and 83.2% of infants between 13 and 24 months, of which 35% and 2.7% had never eaten fish, respectively. 45 infants were fed only with formula and complementary feeding, 28 (62%) of them received ≥ 1 g/kg/day of protein from infant formula. CONCLUSIONS: Most infants were exclusively breastfed until 6 months old and incorporated complementary feeding at that age. Most infants incorporated legumes, eggs, and fish later than recommended, and there was excessive consumption of beef, chicken, or turkey and little consumption of fish, especially at older ages.

Preventing first births among adolescents in Mexico City's public abortion programme.

INTRODUCTION: We examined parity and age among women seeking an abortion in Mexico City's public first-trimester abortion programme, Interrupcion Legal de Embarazo (ILE). We hypothesised that younger women, especially students, used abortion to prevent first births while older women used abortion to limit births. METHODS: We used clinical data from a sample of 47 462 women who had an abortion between 2007 and 2016 and classified them as nulliparous or parous according to previous births prior to the abortion. We used logistic regression to identify sociodemographic and clinical factors associated with using abortion to prevent a first birth (nulliparous) versus limiting births (parous) and calculated absolute multivariable predicted probabilities. RESULTS: Overall, 41% of abortions were in nulliparous women seeking to prevent a first birth, and 59% were in women who already had one or more children. The adjusted probability of using abortion to prevent a first birth was 80.4% (95% CI 78.3 to 82.4) for women aged 12-17 years and 54.3% (95% CI 51.6 to 57.0) for women aged 18-24 years. Adolescents (aged 12-17 years) who were employed or students had nearly 90% adjusted probability of using abortion to prevent a first birth (employed 87.8%, 95% CI 82.9 to 92.8; students 88.5%, 95% CI 82.9 to 94.1). At all ages, employed women and students had higher probabilities of using abortion to prevent a first birth compared with unemployed women and women who work in the home. CONCLUSION: Legal first-trimester abortion services in Mexico can help prevent first births in adolescents, especially students.

Transition to adulthood in Latin America: 1960s-2010s / Transição para a vida adulta na América Latina: 1960-2010 / Transición a la adultez en América Latina 1960-2010

Multidimensional discussion about transition to adulthood is an incipient theme in Latin America. This paper seeks to describe and characterize the process of change in the transition of men and women in the region between the 1960s and 2010's. Using census data from IPUMS-International for 15 Latin American countries, we calculate the mean ages at transition to adulthood, at entering the labor market, at first union, and at first birth. We concluded there was a process of postponing transition to adulthood, although much stronger for males than for females, which we attribute to the events linked to the transition of each group. With these results, we hope to encourage further research into transition to adulthood in Latin America.

A transição para a vida adulta é um tema pouco explorado de forma multidimensional na América Latina. Este artigo busca descrever e caracterizar o processo de mudança na transição de homens e mulheres na região, entre 1960 e 2010. Utilizando dados censitários fornecidos pela plataforma IPUMS para 15 países latino-americanos, foram calculadas as idades médias na transição para a vida adulta, no ingresso no mercado de trabalho, na primeira união e no nascimento do primeiro filho. Conclui-se que houve um processo de postergação da transição para a vida adulta, porém, foi muito mais forte para os homens do que para as mulheres, o que pode ser atribuído aos acontecimentos ligados à transição de cada grupo. Com esses resultados, esperamos encorajar mais investigações sobre a transição para a vida adulta na América Latina.

La transición a la adultez es un tema poco explorado de manera multidimensional en América Latina. Este artículo busca describir y caracterizar el proceso de cambio en la transición de hombres y mujeres en la región entre las décadas de 1960 y 2010. Utilizando datos censales proporcionados por la plataforma IPUMS para 15 países de América Latina, calculamos las edades medias en la transición a la edad adulta, entrada al mercado laboral, primera unión y primer nacimiento. Concluimos que hubo un proceso de postergación de la transición a la adultez que fue mucho más fuerte para los hombres que para las mujeres, lo que atribuimos a los hechos relacionados con la transición de cada grupo. Con estos resultados esperamos impulsar nuevas investigaciones sobre la transición a la vida adulta en América Latina.

The relationship between fraternal birth order and childhood sex-atypical behavior among the Istmo Zapotec muxes.

Research on male androphilia (i.e., sexual attraction towards adult males) consistently finds that androphilic males tend to have more older biological brothers than males who are gynephilic (i.e., sexually attracted to adult females). This fraternal birth order effect (FBOE) has been well replicated among androphilic males who present publically in a male-typical (cisgender) and a female-typical (transgender) manner. There is some evidence that the FBOE is more pronounced among transgender androphilic males. However, no studies have directly compared both forms of male androphilia within the same culture. This study tested the FBOE, and its association with childhood sex-atypical behavior (CSAB), among the Istmo Zapotec of Oaxaca, Mexico, where both forms of male androphilia are referred to as a third gender, muxes. Our results indicated that both cisgender muxe nguiiu (n = 124) and transgender muxe gunaa (n = 120) were more likely to be later born among brothers than gynephilic men (n = 194). However, the number of older brothers did not differentiate between transgender and cisgender muxes, nor did it predict CSAB among muxes. These findings replicate the FBOE among both cisgender and transgender muxes but show no evidence that it is more pronounced among transgender androphilic males.

Birth weight, birth order, and age at first solid food introduction influence child growth and body composition in 6- to 8-year-old Maya children: The importance of the first 1000 days of life.

OBJECTIVES: To analyze the relationship of birth weight, birth order, breastfeeding duration, and age of introduction of solid foods with height, fat mass, and fat-free mass in a sample of Maya children when aged 6 to 8 years old. METHODS: We collected data on anthropometry, body composition, children's birth weight, birth order, early feeding practices, and household socioeconomic characteristics in a sample of 260 Maya children aged 6 to 8 years living in Merida and Motul, two cities in Yucatan, Mexico. Multiple regression models were performed to identify variables associated with height-for-age (HAZ), fat mass index (FMI), and fat-free mass index (FFMI). The predictors included in the models were birth weight (kg), birth order, duration of breastfeeding (months), age at introduction of solid foods (months), maternal age (years), and height (cm). Models were adjusted for the influence of children's age and sex, maternal educational level, and household overcrowding. RESULTS: HAZ was positively associated with child birthweight and maternal height and age, but inversely associated with birth order and age of introduction of solid foods. FMI was positively associated with birth weight, maternal age, and height, and negatively associated with birth order. FFMI was positively associated with maternal age and birth weight. CONCLUSIONS: These results are evidence of the importance of the first 1000 days of life for the growth and body composition of Maya children and contributed to understand the development of nutritional dual burden in this population.

Sex ratio and maternal age in a natural fertility, subsistence population: Daughters, sons, daughters.

OBJECTIVE: To evaluate putative links between birth sex ratios (BSR = male:female births) and maternal age in a traditional, agricultural, natural fertility population. Metabolic energy, social support, and the costs and benefits associated with producing sons versus daughters can affect BSR. These variables fluctuate with maternal age. Most studies evaluating links between maternal age and BSR have been based on industrialized populations, which differ importantly from traditional indigenous communities in terms of the aforementioned socio-ecological variables. MATERIALS AND METHODS: We analyze data from 108 mothers and their 603 children living in an agricultural, pronatalist, Kakchiquel Mayan community. RESULTS: A logistic regression model, including linear and quadratic maternal age terms and women-specific random effects, shows a nonmonotonic (p = .028) relationship between log BSR and maternal age. For maternal age ≤ 22, the upper bound of the 95% confidence interval (CI) for BSR is <1, suggesting a bias toward girls. The probability of birthing a son increased early during the average mother's reproductive career, peaked at age 31.3 (approximately 95% CI = 27.1, 35.5), and decreased as she approached her perimenopausal period (p = .014). DISCUSSION: No changes in mating system, population sex ratio, mortality patterns, natural disasters, social risk, or toxic exposures were observed and thus are unlikely to explain our results. At this point, age-related changes in metabolic energy, social support, and costs and benefits associated with offspring sex cannot be excluded as possible explanations. BSR can affect growth, morbidity, and mortality. Thus, our results are relevant to numerous fields, including anthropology, ecology, demography, and public health.

Birthweight and pelvic floor trauma after vaginal childbirth.

INTRODUCTION AND HYPOTHESIS: Birthweight seems to be a risk factor for levator ani muscle (LAM) avulsion and a predictive factor for pelvic organ prolapse (POP). Most trauma seems due to first vaginal birth. METHODS: One thousand one hundred twenty-five women with at least two vaginal deliveries underwent a physician-directed interview, followed by clinical examination (digital palpation and Pelvic Organ Prolapse Quantification-POPQ) and 4D translabial ultrasound. Ultrasound volume data were obtained at rest, on pelvic floor contraction and Valsalva. The investigator, blinded to all other data, performed offline analysis of the LAM integrity and hiatal area on Valsalva. We tested for associations between birthweight of the first and of the largest vaginally born baby on the one hand and avulsion and symptoms/signs of prolapse on the other hand. RESULTS: Between July 2014 and July 2017, 1575 patients were seen. After exclusion of nulliparae and women with just one vaginal birth, 1202 remained. Another 77 were excluded due to missing data, leaving 1125. A significant association was found between birthweight and LAM avulsion as well as significant prolapse on POPQ. The birthweight of the first vaginally born baby was at least as predictive for avulsion as the birthweight of any subsequent births, even when adjusted for maternal age at first delivery and use of forceps. CONCLUSIONS: The birthweight of the first vaginally born baby is associated with levator avulsion and subsequent POP. Maximum weight of vaginal births does not seem to be a stronger predictor.

Sibship, physical activity, and sedentary behavior: a longitudinal, observational study among Mexican-heritage sibling dyads.

BACKGROUND: Shared genetic and environmental factors suggest that family relationships are important predictors of obesity-related behaviors, yet little is known about how siblings influence physical activity and sedentary behaviors. This study examined physical activity and sedentary behavior between sibling dyads across summer and fall time points and determined if birth order and gender modify the relationship between sibling behaviors. METHODS: Mexican-heritage families residing in colonias along the United States-Mexico border were recruited using promotoras de salud to participate in summer and school year surveys. Eighty-seven sibling dyads had complete data for the physical activity sub-study: 21 older brother-younger brother, 21 older brother-younger sister, 23 older sister-younger brother, and 22 older sister-younger sister dyads. Physical activity and sedentary behavior were measured using a validated 7-day recall instrument to create summary measures of weekly active, moderate-to-vigorous physical activity (MVPA) metabolic equivalents (MET), sitting, and screen time minutes. We used linear regression analyses to examine changes over time and the association between older and younger sibling behavior. RESULTS: During summer, older siblings (mean age = 11.2 years) reported 1069 active minutes and 1244 sitting minutes per week; younger siblings (mean age = 8.3 years) reported 1201 active minutes and 1368 sitting minutes per week. Younger brothers reported fewer active minutes (mean = - 459.6; p = 0.01) and fewer MVPA MET-minutes (mean = - 2261.7; p = 0.02) of physical activity during the fall. Within all 87 dyads, older sibling physical activity was significantly associated with younger sibling active minutes (B = 0.45;p = 0.004) and MET-minutes (B = 0.45;p = 0.003) during summer but not fall; older sibling sedentary behavior was significantly associated with younger sibling sitting (B = 0.23;p = 0.01) and screen time minutes (B = 0.23;p = 0.004) during fall but not summer. After stratifying by gender dyad groups, younger brother behavior was strongly associated with older brother behavior at both time points. CONCLUSION: Younger siblings appear to emulate the physical activity behaviors of their older siblings during non-school summer months and sedentary behaviors of older siblings during school-time fall months, especially older brother-younger brother dyads. Family-based interventions to increase physical activity and decrease sedentary behavior are growing in popularity, but more work is needed to understand the role of sibling influences.

Physiological and metabolic responses in newborn piglets associated with the birth order.

The objective of this study was to evaluate the effect of birth order on the physiological and metabolic responses of the newborn piglet the first hours after birth. A total of 281 randomly selected newborn piglets were included, classified according to birth order in 12 groups (L1-L12). The expulsion interval, neonatal vitality, latency in connecting to the maternal teat and physiological profile were recorded for each piglet. The number of piglets born alive and dead was also recorded. The blood gases, electrolytes and glucose levels of the neonates were obtained by means of an automatic blood gas and electrolyte analyzer. Groups L1, L2, L11, and L12 had the least score on the vitality scale, the longest expulsion intervals, and longest latency to connect with the maternal teat, as well as greater physiological alterations (hyperglycemia, hyperlactatemia and hypercapnia) compared to groups L4 to L9. Likewise, type-II stillbirths only occurred in the first and last quarter of the birth order of the litter. In conclusion, piglets born in the first and last quarter of the birth order of the litter had a greater risk of having physiological and behavioral alterations during farrowing.

Birth order and number of siblings and their association with overweight and obesity: a systematic review and meta-analysis.

Context: The effect of both birth order and number of siblings on overweight and/or obesity has not been determined. Birth order and sibsize have been mathematically coupled to overweight and/or obesity, but thus far their respective effects have been estimated separately. Objective: The aim of this systematic review was to evaluate the effects of both birth order and number of siblings on the risk of overweight/obesity. Data Sources: The electronic databases MEDLINE, Social Science, SocINDEX, PsycINFO, CINAHL Plus, and Academic Search Complete were searched systematically. Study Selection: Titles and abstracts of 1698 records were examined. After 1504 records were excluded, 2 authors independently assessed the full text of all remaining papers (n = 194); disagreements were resolved by discussion. Data Extraction: A standardized form for assessment of study quality and evidence synthesis was used to extract data from the included studies. Results: Twenty studies were included in the systematic review, 14 of which were included in the meta-analysis. Meta-analyses showed that lower (vs higher) birth order and smaller (vs greater) number of siblings were associated with overweight and/or obesity, with ORs of 1.47 (95%CI, 1.12-1.93) and 1.46 (95%CI, 1.17-1.84), respectively. However, among the 9 studies that attempted to separate the effects of birth order and number of siblings in the same analysis, a higher risk of overweight/obesity was consistently found among individuals without siblings than among those with 1 or more siblings, rather than among firstborns more generally. Conclusion: The results show that both lower birth order and lower number of siblings are associated with risk of overweight/obesity, which suggests that only children are at a slightly increased risk of overweight/obesity. Systematic Review Registration: PROSPERO registration number CRD42014015135.

[Trauma and resilience among children 3 to 6 years old in three neighborhoods of Port-au-Prince after the 2010 earthquake in Haiti]. / Traumatismes et résiliences chez les enfants de 3 à 6ans dans trois quartiers de Port-au-Prince après le séisme de 2010 en Haïti.

The paper describes an action research for indicative assessment of psychological problems of young children following the 2010 earthquake in Haiti, and the interest of using the Creole version of the questionnaire PSYCa 3-6. The survey took place in Port-au-Prince, and the evaluators were trained to a proper standardized administration of the questionnaire. BACKGROUND: The mental health needs of young children in natural disaster contexts often remain unaddressed. The lack of a rapid and simple tool for screening combined with few mental health professionals available to accurately diagnose and provide appropriate care mean that young children remain without care. Here, we present the results of psychological screening of young children aged 3 to 6 using the questionnaire PSYCa 3-6. METHODS: This study was conducted in Port-au-Prince, Haiti. The scale was translated into Haitian Creole using corroboration of independent translations and submitted twice to the parents at home, at the end of 2011 and again at the beginning of 2013. At the first stage 166 children 3 to 6 years old were included 49 of whom were included at the second stage. The results and diagnostic properties were assessed comparing the PSYCa 3-6 to the Clinical Global Impression Severity Scale as the gold standard. RESULTS: Boys were more prone to psychological disturbances than girls. The size and position among the siblings increased the score of psychological disturbance. The neighborhood and the perception of environmental violence had a significant impact on the score of psychological disturbance. The significant improvement in scores between the two examinations showed moderate resiliency whose main factors seemed to be the social support received by the family, the rapid return to school, faith and religious practice.

BIRTH ORDER AND ANDROPHILIC MALE-TO-FEMALE TRANSSEXUALISM IN BRAZIL.

Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

Birth interval and stunting in children under five years of age in Peru (1996-2014).

BACKGROUND: Examine the evolution of stunting in <5 years of age in Peru and its relationship with birth interval (BI), and associated factors from 1996 to 2014. METHODS: Data were extracted from the National Demographic and Health Survey of Peru (DHS) for the years 1996, 2000, 2005, 2010 and 2014 on children <5 years of age for stunting (height / age ≤ 2DS). The main independent variable of interest was BI dichotomized by interval between date of last and penultimate birth (≤24 months vs. >24 months) and others sociodemographic variables. Crude and adjusted odds ratios with 95% confidence intervals were estimated in logistic regression for the effect of BI and other variables on stunting by each survey year. RESULTS: Between 1996 and 2014, stunting declined in both BI groups: ≤24 months: 35.8% to 21.8%; >24 months: 29.5% to 14.3%. BI was associated with stunting after adjustment for other variables in each survey except 2005. Of the other factors, sex, birth order (fourth child or more), maternal education and poverty were independently associated with stunting in all survey years. Residence in rural areas and in Amazon forest and highland regions was associated with stunting 1996 and 2000. Maternal age was not independently associated with stunting. CONCLUSIONS: While stunting showed a decreasing trend from 1996 to 2014, birth interval exceeding 24 months exerted a protective effect on stunting across the years surveyed. Poverty, low maternal education and high birth order were associated with stunting in all survey years.

Community social capital on the timing of sexual debut and teen birth in Nicaragua: a multilevel approach.

BACKGROUND: Community attributes have been gradually recognized as critical determinants shaping sexual behaviors in young population; nevertheless, most of the published studies were conducted in high income countries. The study aims to examine the association between community social capital with the time to sexual onset and to first birth in Central America. METHODS: Building upon the 2011/12 Demographic and Health Survey conducted in Nicaragua, we identified a sample of 2766 community-dwelling female adolescents aged 15 to 19 years. Multilevel survival analyses were performed to estimate the risks linked with three domains of community social capital (i.e., norms, resource and social network). RESULTS: Higher prevalence of female sexual debut (norms) and higher proportion of secondary school or higher education (resource) in the community are associated with an earlier age of sexual debut by 47 % (p < 0.05) and 16 %, respectively (p < 0.001). Living in a community with a high proportion of females having a child increases the hazard of teen birth (p < 0.001) and resource is negatively associated with teen childbearing (p < 0.05). Residential stability and community religious composition (social network) were not linked with teen-onset sex and birth. CONCLUSIONS: The norm and resource aspects of social capital appeared differentially associated with adolescent sexual and reproductive behaviors. Interventions aiming to tackle unfavorable sexual and reproductive outcomes in young people should be devised and implemented with integration of social process.

Association between order of birth and chronic malnutrition of children: a study of nationally representative Bangladeshi sample.

This paper examines the net effect of birth order on child nutritional status in Bangladesh using data from the Bangladesh Demographic Health Survey, 2011 (BDHS). Analyses were restricted to 4,120 surviving, lastborn singleton children who were younger than 36 months at the time of the survey. Logistic regression was used to assess the association between birth order and child nutritional status. Results indicate 38.1% children are stunted and 8.2% children are fifth or higher order birth. Order of birth is one of the significant predictors of child being stunted. Third order, fourth order, and fifth or higher order children are 24%, 30%, and 72%, respectively, more likely to be stunted after adjusting for all other variables. Besides birth order, results also indicate that child age, size at birth, birth intention, maternal education, maternal body mass index, wealth index, place of residence and mass media access exert strong influences over child malnutrition. Reducing birth rates which limit number of births and birth order as well may reduce child malnutrition in Bangladesh.

Association between order of birth and chronic malnutrition of children: a study of nationally representative Bangladeshi sample / Associação entre ordem de nascimento e desnutrição crônica em crianças: estudo de uma amostra nacional representativa em Bangladesh / Asociación entre el orden de nacimiento y la desnutrición crónica infantil: un estudio de una muestra representativa Bangladesí a nivel nacional

Abstract This paper examines the net effect of birth order on child nutritional status in Bangladesh using data from the Bangladesh Demographic Health Survey, 2011 (BDHS). Analyses were restricted to 4,120 surviving, lastborn singleton children who were younger than 36 months at the time of the survey. Logistic regression was used to assess the association between birth order and child nutritional status. Results indicate 38.1% children are stunted and 8.2% children are fifth or higher order birth. Order of birth is one of the significant predictors of child being stunted. Third order, fourth order, and fifth or higher order children are 24%, 30%, and 72%, respectively, more likely to be stunted after adjusting for all other variables. Besides birth order, results also indicate that child age, size at birth, birth intention, maternal education, maternal body mass index, wealth index, place of residence and mass media access exert strong influences over child malnutrition. Reducing birth rates which limit number of births and birth order as well may reduce child malnutrition in Bangladesh.

Resumo O estudo analisa o efeito ajustado da ordem de nascimento sobre estado nutricional em crianças de Bangladesh, com base em dados do Inquérito Nacional de Demografia e Saúde daquele país (BDHS) em 2011. As análises se limitaram a 4.120 nascidos vivos de parto único, últimos na ordem de nascimento e vivos e com menos de 36 meses de idade no momento do inquérito. A regressão logística foi utilizada para avaliar a associação entre ordem de nascimento e estado nutricional. Segundo os resultados, 38,1% das crianças apresentavam baixa estatura para a idade e 8,2% ocupavam quinto lugar ou mais na ordem de nascimento. A ordem de nascimento é preditor significativo de baixa estatura para a idade em crianças de Bangladesh. A terceira, quarta ou quinta posição ou mais na ordem de nascimento mostrou um aumento de probabilidade de 24%, 30% e 72%, respectivamente, de baixa estatura para a idade, depois de ajustar para todas as outras variáveis. Além da ordem de nascimento, os resultados indicam que a idade da criança, comprimento cabeça-nádega ao nascer, intenção da gravidez, escolaridade materna, índice de massa corporal materna, índice de riqueza familiar, lugar de residência e acesso aos meios de comunicação de massa têm forte influência sobre a desnutrição infantil. A redução da taxa de natalidade e consequente limitação do número de nascimentos e da ordem de nascimento podem também reduzir a desnutrição infantil em Bangladesh.

Resumen Este trabajo analiza el efecto neto del orden de nacimiento en el status nutricional infantil en Bangladés, utilizando datos de la Encuesta Demográfica Bangladesí sobre la Salud, 2011 (BDHS). Los análisis se restringieron a los últimos 4,120 bebés nacidos vivos, procedentes de un embarazo único, y que fueran menores de 36 meses en el momento de la realización de la encuesta. Se usó la regresión logística para evaluar la asociación entre el orden de nacimiento y el estado nutricional infantil. Los resultados indican que un 38.1% de los niños sufren retraso en su crecimiento y un 8.2% de los niños ocupan el quinto o un orden más elevado de nacimiento. El orden de nacimiento es uno de los predictores significativos del retraso en el crecimiento en los niños. Quienes ocupan el tercer, cuarto, quinto o puestos más elevados en este orden son niños que en un 24%, 30% y un 72%, respectivamente, tienen más probabilidad de sufrir retraso en su crecimiento tras ajustar para todos otras variables. Asimismo, los resultados en el orden del nacimiento también indicaban que la edad y tamaño del niño tras el parto, así como el carácter del nacimiento, la educación materna, el índice de masa corporal materna, de riqueza, el lugar de residencia y el acceso a medios de comunicación ejercen fuertes influencias sobre la desnutrición infantil. Reduciendo la tasa de natalidad que limita el número de nacimientos y el orden de nacimientos se podría llegar a reducir la desnutrición infantil en Bangladés.