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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(3): 332-336, 2020 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-32187942

RESUMO

Thallium is a highly toxic heavy metal. The adverse maternal and infant health effects caused by thallium exposure during pregnancy have also attracted more and more scholars' attention. This study focused on the sources of thallium exposure and its influencing factors, the association between thallium exposure during pregnancy and pregnancy complications and adverse birth outcomes in newborns, the effects of thallium exposure during pregnancy on children's growth and development after birth. In terms of potential mechanisms, the related research progress was reviewed in this study, which could provide a new basis for further research on the harm, prevention and control of thallium exposure during pregnancy.


Assuntos
Poluentes Ambientais/toxicidade , Exposição Materna/efeitos adversos , Complicações na Gravidez , Efeitos Tardios da Exposição Pré-Natal , Tálio/toxicidade , Criança , Poluentes Ambientais/metabolismo , Feminino , Humanos , Lactente , Saúde do Lactente , Recém-Nascido , Período Periparto , Gravidez
3.
N C Med J ; 81(1): 24-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31908328

RESUMO

In working to improve the health of North Carolinians, a critical focus starts with our mothers and infants and their surrounding communities. North Carolina's perinatal outcomes, as evidenced by maternal morbidity and mortality, infant mortality, preterm births, and the larger context of lifelong physical and mental health of our citizens, offer areas for improvement and policy implications. In addition, the unacceptable disparities that remain despite some overall improvement in outcomes warrant full attention. This issue of the NCMJ highlights the state of perinatal health in North Carolina; the importance of a risk-appropriate perinatal system of care; the opportunities for supporting our parents, children, and families; and how we as a state and as a community can come together to improve the safety and experience of giving birth in North Carolina and beyond.


Assuntos
Saúde do Lactente/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Feminino , Humanos , Lactente , Mortalidade Infantil/tendências , Recém-Nascido , Mortalidade Materna/tendências , North Carolina/epidemiologia , Gravidez , Nascimento Prematuro/epidemiologia
5.
Matern Child Health J ; 24(Suppl 1): 31-38, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31848924

RESUMO

INTRODUCTION: Nepal has pledged to substantially reduce maternal and newborn death by 2030. Improving quality of intrapartum health services will be vital to reduce these deaths. This paper examines quality of delivery and newborn services in health facilities of Nepal. METHODS: Data were sourced from the Nepal Health Facility Survey 2015, which covered a national representative sample of health facilities. The datasets were analysed to assess service readiness, availability and quality of delivery and newborn care in a sample of 992 health facilities. RESULTS: Of the 992 facilities in the sample, 623 provided delivery and newborn care services. Of the 623 facilities offering delivery and newborn care services, 13.3% offered comprehensive emergency obstetric care (CEmONC), 19.6% provided basic emergency obstetric care (BEmONC) and 53.9% provided basic delivery and newborn service. The availability of essential equipment for delivery and newborn care was more than 80% in health facilities. Except for the coverage of vitamin K injection, the coverage of immediate newborn care was more than 85% in all health facilities. The coverage of use of chlorhexidine ointment to all newborns was more than 70% in government hospitals and primary health care centers (PHCCs) and only 32.3% in private hospitals. CONCLUSIONS: These findings show gaps in equipment and drugs, especially in PHCCs and private health facilities. Improving readiness and availability of equipment and drugs in PHCCs and private health facility will help improve the quality of care to further reduce maternal and newborn mortality in Nepal.


Assuntos
Serviços de Saúde da Criança/organização & administração , Serviços Médicos de Emergência/organização & administração , Instalações de Saúde/estatística & dados numéricos , Serviços de Saúde Materna/organização & administração , Atenção Primária à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde , Feminino , Acesso aos Serviços de Saúde , Humanos , Saúde do Lactente , Recém-Nascido , Nepal , Gravidez
6.
J Glob Health ; 9(2): 0204249, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31788233

RESUMO

Background: mHealth technology holds promise for improving the effectiveness of frontline health workers (FLWs), who provide most health-related primary care services, especially reproductive, maternal, newborn, child health and nutrition services (RMNCHN), in low-resource - especially hard-to-reach - settings. Data are lacking, however, from rigorous evaluations of mHealth interventions on delivery of health services or on health-related behaviors and outcomes. Methods: The Information Communication Technology-Continuum of Care Service (ICT-CCS) tool was designed for use by community-based FLWs to increase the coverage, quality and coordination of services they provide in Bihar, India. It consisted of numerous mobile phone-based job aids aimed to improve key RMNCHN-related behaviors and outcomes. ICT-CCS was implemented in Saharsa district, with cluster randomization at the health sub-center level. In total, evaluation surveys were conducted with approximately 1100 FLWs and 3000 beneficiaries who had delivered an infant in the previous year in the catchment areas of intervention and control health sub-centers, about half before implementation (mid-2012) and half two years afterward (mid-2014). Analyses included bivariate and difference-in-difference analyses across study groups. Results: The ICT-CCS intervention was associated with more frequent coordination of AWWs with ASHAs on home visits and greater job confidence among ASHAs. The intervention resulted in an 11 percentage point increase in FLW antenatal home visits during the third trimester (P = 0.04). In the post-implementation period, postnatal home visits during the first week were increased in the intervention (72%) vs the control (60%) group (P < 0.01). The intervention also resulted in 13, 12, and 21 percentage point increases in skin-to-skin care (P < 0.01), breastfeeding immediately after delivery (P < 0.01), and age-appropriate complementary feeding (P < 0.01). FLW supervision and other RMNCHN behaviors were not significantly impacted. Conclusions: Important improvements in FLW home visits and RMNCHN behaviors were achieved. The ICT-CCS tool shows promise for facilitating FLW effectiveness in improving RMNCHN behaviors.


Assuntos
Agentes Comunitários de Saúde , Promoção da Saúde/métodos , Telemedicina , Criança , Saúde da Criança , Feminino , Humanos , Índia , Saúde do Lactente , Recém-Nascido , Saúde Materna , Serviços de Saúde Materno-Infantil/organização & administração , Estado Nutricional , Gravidez , Avaliação de Programas e Projetos de Saúde , Saúde Reprodutiva , Serviços de Saúde Reprodutiva/organização & administração
7.
PLoS One ; 14(12): e0221691, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31887122

RESUMO

BACKGROUND: Globally, low birthweight (LBW) infants (<2.5 kilograms) contribute up to 80% of neonatal mortality. In Bangladesh, approximately 62% of all births occur at home and therefore, weighing newborns immediately after birth is not feasible. Thus, estimates of birthweight in Bangladesh are mostly obtained based on maternal perception of the newborn's birth size. Little is known about how birthweight is perceived in rural communities, and whether families associate birthweight with newborn's health status. Our objective was to explore families' perceptions of newborn's birthweight, and preventive and care practices for a LBW newborn in rural Bangladesh. METHODS: We conducted a qualitative study in two rural settings of Bangladesh, including 32 in-depth interviews (11 with pregnant women, 12 with recently delivered women, 4 with husbands whose wives were pregnant or had a recent birth, 5 with mothers-in-law whose daughters-in-law were pregnant or had a recent birth), 2 focus group discussions with husbands and 4 key-informant interviews with community health workers. We used thematic analysis to analyse the data. RESULTS: Most participants did not consider birthweight a priority for assessing a newborn's health status, although there was a desire for a healthy newborn. Recognition of different categories of birthweight was subjective and often included several physical descriptors including birth size of the newborn. LBW was not considered as a criterion of a newborn's illness unless the newborn appeared unwell. Maternal poor nutrition, inadequate diet in pregnancy, anaemia, illness during pregnancy, short stature, twin births and influence of supernatural spirit were identified as the major causes of LBW. Women's preventive practices for LBW or small newborns were predominantly constrained by a lack of awareness of birthweight and fear of caesarean section. As an effort to avoid caesarean section during birth, several women tended to perform potentially harmful practices in order to give birth to a small size newborn; such as avoiding nutritious food and eating less in pregnancy. Common practices to treat a LBW or small newborn who appeared ill included breastfeeding, feeding animal milk, feeding sugary water, feeding formula, oil massage, keeping the small newborn warm and seeking care from formal and informal care providers including a spiritual leader. Maternal lack of decision-making power, financial constraint, home birth and superstition were the major challenges to caring for a LBW newborn. CONCLUSION: Birthweight was not well-understood in the rural community, which highlighted substantial challenges to the prevention and care practices of LBW newborns. Community-level health education is needed to promote awareness related to the recognition of birthweight in rural settings.


Assuntos
Parto Domiciliar/ética , Saúde do Lactente/etnologia , Saúde do Lactente/tendências , Adulto , Bangladesh/epidemiologia , Peso ao Nascer , Cesárea , Feminino , Parto Domiciliar/tendências , Humanos , Renda , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Mães/psicologia , Parto , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , População Rural , Fatores Socioeconômicos
8.
Ann Agric Environ Med ; 26(4): 617-622, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885236

RESUMO

INTRODUCTION: In epidemiology, generalized linear models are the main statistical methods used to explore associations. However, the use of other methods such as Structural Equation Modelling (SEM) is gradually increasing. OBJECTIVE: The aim of the study was to illustrate the use of SEM in the assessment of salivary cortisol concentration in infants as a biomarker of perinatal exposure to inorganic arsenic. MATERIAL AND METHODS: This was a cohort study of pregnant women recruited from public health care centres in Arica, Chile, in 2013. Socio-demographic information and urine samples to assess inorganic arsenic were collected during the second trimester of pregnancy. Saliva samples were collected to assess cortisol in infants between 18-24 months of age. Four linear regression models (LRMs) and two SEMs were run to estimate the effect of prenatal exposure to inorganic arsenic on cortisol concentration in infants. RESULTS: According to LRMs and SEMs, prenatal exposure to inorganic arsenic and salivary cortisol were not associated. However, the association between maternal cortisol and cortisol in infants was statistically significant in all models; for each increase in standard deviation of the covariate Ln(maternal cortisol), the outcome Ln(cortisol in infant) increased by 0.49 units of variance in both SEMs. CONCLUSIONS: LRMs and SEMs were useful to assess the effect of prenatal exposure to inorganic arsenic on cortisol in infants. However, SEM allowed the adjustment of estimations by an estimated latent that obtained the information about income, occupation, education and ethnicity in a more comprehensive way than achieved by LRM.


Assuntos
Arsênico/análise , Hidrocortisona/análise , Saúde do Lactente , Exposição Materna/efeitos adversos , Adulto , Arsênico/toxicidade , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Modelos Estatísticos , Gravidez , Saliva/química
10.
Cochrane Database Syst Rev ; 2019(11)2019 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-31686427

RESUMO

BACKGROUND: In low- and middle-income countries (LMICs), health services are under-utilised, and several studies have reported improvements in neonatal outcomes following health education imparted to mothers in homes, at health units, or in hospitals. However, evaluating health educational strategy to deliver newborn care, such as one-to-one counselling or group counselling via peer or support groups, or delivered by health professionals, requires rigorous assessment of methodological design and quality, as well as assessment of cost-effectiveness, affordability, sustainability, and reproducibility in diverse health systems. OBJECTIVES: To compare a community health educational strategy versus no strategy or the existing approach to health education on maternal and newborn care in LMICs, as imparted to mothers or their family members specifically in community settings during the antenatal and/or postnatal period, in terms of effectiveness for improving neonatal health and survival (i.e. neonatal mortality, neonatal morbidity, access to health care, and cost). SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 4), in the Cochrane Library, MEDLINE via PubMed (1966 to 2 May 2017), Embase (1980 to 2 May 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 2 May 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Community-based randomised controlled, cluster-randomised, or quasi-randomised controlled trials. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted the data. We assessed the quality of evidence using the GRADE method and prepared 'Summary of findings' tables. MAIN RESULTS: We included in this review 33 original trials (reported in 62 separate articles), which were conducted across Africa and Central and South America, with most reported from Asia, specifically India, Pakistan, and Bangladesh. Of the 33 community educational interventions provided, 16 included family members in educational counselling, most frequently the mother-in-law or the expectant father. Most studies (n = 14) required one-to-one counselling between a healthcare worker and a mother, and 12 interventions involved group counselling for mothers and occasionally family members; the remaining seven incorporated components of both counselling methods. Our analyses show that community health educational interventions had a significant impact on reducing overall neonatal mortality (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.78 to 0.96; random-effects model; 26 studies; n = 553,111; I² = 88%; very low-quality evidence), early neonatal mortality (RR 0.74, 95% CI 0.66 to 0.84; random-effects model; 15 studies that included 3 subsets from 3 studies; n = 321,588; I² = 86%; very low-quality evidence), late neonatal mortality (RR 0.54, 95% CI 0.40 to 0.74; random-effects model; 11 studies; n = 186,643; I² = 88%; very low-quality evidence), and perinatal mortality (RR 0.83, 95% CI 0.75 to 0.91; random-effects model; 15 studies; n = 262,613; I² = 81%; very low-quality evidence). Moreover, community health educational interventions increased utilisation of any antenatal care (RR 1.16, 95% CI 1.11 to 1.22; random-effects model; 18 studies; n = 307,528; I² = 96%) and initiation of breastfeeding (RR 1.56, 95% CI 1.37 to 1.77; random-effects model; 19 studies; n = 126,375; I² = 99%). In contrast, community health educational interventions were found to have a non-significant impact on use of modern contraceptives (RR 1.10, 95% CI 0.86 to 1.41; random-effects model; 3 studies; n = 22,237; I² = 80%); presence of skilled birth attendance at birth (RR 1.09, 95% CI 0.94 to 1.25; random-effects model; 10 studies; n = 117,870; I² = 97%); utilisation of clean delivery kits (RR 4.44, 95% CI 0.71 to 27.76; random-effects model; 2 studies; n = 17,087; I² = 98%); and care-seeking (RR 1.11, 95% CI 0.97 to 1.27; random-effects model; 7 studies; n = 46,154; I² = 93%). Cost-effectiveness analysis conducted in seven studies demonstrated that the cost-effectiveness for intervention packages ranged between USD 910 and USD 11,975 for newborn lives saved and newborn deaths averted. For averted disability-adjusted life-year, costs ranged from USD 79 to USD 146, depending on the intervention strategy; for cost per year of lost lives averted, the most effective strategy was peer counsellors, and the cost was USD 33. AUTHORS' CONCLUSIONS: This review offers encouraging evidence on the value of integrating packages of interventions with educational components delivered by a range of community workers in group settings in LMICs, with groups consisting of mothers, and additional education for family members, for improved neonatal survival, especially early and late neonatal survival.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Aconselhamento/métodos , Mortalidade Infantil , Mães/educação , Mortalidade Perinatal , Países em Desenvolvimento , Feminino , Educação em Saúde , Humanos , Lactente , Saúde do Lactente , Recém-Nascido , Serviços de Saúde Materna/organização & administração , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Matern Child Health J ; 23(12): 1658-1669, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31584144

RESUMO

Objectives mHealth interventions for MNCH have been shown to improve uptake of antenatal and neonatal services in low- and middle-income countries (LMICs). However, little systematic analysis is available about their impact on infant health outcomes, such as reducing low birth weight or malnutrition among children under the age of five. The objective of this study is to determine if an age- and stage-based mobile phone voice messaging initiative for women, during pregnancy and up to 1 year after delivery, can reduce low birth weight and child malnutrition and improve women's infant care knowledge and practices. Methods We conducted a pseudo-randomized controlled trial among pregnant women from urban slums and low-income areas in Mumbai, India. Pregnant women, 18 years and older, speaking Hindi or Marathi were enrolled and assigned to receive mMitra messages (intervention group N = 1516) or not (Control group N = 500). Women in the intervention group received mMitra voice messages two times per week throughout their pregnancy and until their infant turned 1 year of age. Infant's birth weight, anthropometric data at 1 year of age, and status of immunization were obtained from Maternal Child Health (MCH) cards to assess impact on primary infant health outcomes. Women's infant health care practices and knowledge were assessed through interviews administered immediately after women enrolled in the study (Time 1), after they delivered their babies (Time 2), and after their babies turned 1 year old (Time 3). 15 infant care practices self-reported by women (Time 3) and knowledge on ten infant care topics (Time 2) were also compared between intervention and control arms. Results We observed a trend for increased odds of a baby being born at or above the ideal birth weight of 2.5 kg in the intervention group compared to controls (odds ratio (OR) 1.334, 95% confidence interval (CI) 0.983-1.839, p = 0.064). The intervention group performed significantly better on two infant care practice indicators: giving the infant supplementary feeding at 6 months of age (OR 1.4, 95% CI 1.08-1.82, p = 0.009) and fully immunizing the infant as prescribed under the Government of India's child immunization program (OR 1.531, 95% CI 1.141-2.055, p = 0.005). Women in the intervention group had increased odds of knowing that the baby should be given solid food by 6 months (OR 1.89, 95% CI 1.371-2.605, p < 0.01), that the baby needs to be given vaccines (OR 1.567, 95% CI 1.047-2.345, p = 0.028), and that the ideal birth weight is > 2.5 kg (OR 2.279, 95% CI 1.617-3.213, p < 0.01). Conclusions for Practice This study provides robust evidence that tailored mobile voice messages can significantly improve infant care practices and maternal knowledge that can positively impact infant child health. Furthermore, this is the first prospective study of a voice-based mHealth intervention to demonstrate a positive impact on infant birth weight, a health outcome of public health importance in many LMICs.


Assuntos
Telefone Celular , Transtornos da Nutrição Infantil/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/métodos , Desnutrição/prevenção & controle , Mães/psicologia , Voz , Adulto , Criança , Feminino , Humanos , Índia , Lactente , Saúde do Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Áreas de Pobreza , Gravidez , Estudos Prospectivos , Telemedicina , Adulto Jovem
12.
Inquiry ; 56: 46958019884189, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31646919

RESUMO

We assess the association between maternal migrant status and health outcomes in China, which has one of the world's largest migrant populations. Health records from the Shanghai First Maternity and Infant Hospital from January 1, 2013, to June 30, 2017, were used to analyze 104 681 live births for Shanghai native-born and migrant women based on International Classification of Diseases, Tenth Revision diagnosis codes and demographic data. Regression analysis including propensity score matching was conducted to investigate the association between maternal migrant status and adverse infant birth outcomes (fetal disease, congenital malformation, neonatal disease) and maternal health after controlling for pregnancy status and socioeconomic factors. The results demonstrate that migrant women had statistically significant increased odds (9.1%-10%, P < .001) of having infants with adverse health outcomes compared with their urban counterparts and that migrant mothers have less likelihood of pregnancy complications and gestational diabetes mellitus. Our results show the mixed effects of migration on infant and maternal health may be a possible outcome of China's Hukou system that often represents an important barrier in accessing prenatal health care by migrant women. Current reforms that improve access to prenatal health care services for migrant women may enhance the health outcomes of their infants.


Assuntos
Saúde Materna/estatística & dados numéricos , Complicações na Gravidez , Migrantes/estatística & dados numéricos , Adulto , China , Feminino , Acesso aos Serviços de Saúde/organização & administração , Humanos , Lactente , Saúde do Lactente , Recém-Nascido , Gravidez
13.
Int Health ; 11(5): 349-352, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31529111

RESUMO

The Millennium Development Goals era achieved substantial improvements in the health of women and children. Yet progress was uneven and many women and children still suffer from preventable mortality and morbidity. The United Nations Secretary General's Global Strategy for Women's, Children's and Adolescents' Health (2016-2030) set out an ambitious 'survive, thrive and transform' agenda for countries as they accelerate progress towards the health-related Sustainable Development Goals. This review highlights aspects of 'survive, thrive and transform' that have had strong traction globally, namely quality of care and humanitarian settings for 'survive', early childhood development and adolescent health for 'thrive' and community engagement and a sustainable environment for 'transform'.


Assuntos
Saúde do Adolescente , Saúde da Criança , Saúde Global , Saúde do Lactente , Saúde Materna , Adolescente , Criança , Feminino , Humanos , Recém-Nascido , Gravidez , Desenvolvimento Sustentável , Nações Unidas/organização & administração
14.
Artigo em Inglês | MEDLINE | ID: mdl-31533243

RESUMO

Delaying motherhood is becoming increasingly common, raising questions of the possible influence that maternal age may have on newborn health. Therefore, the objective of this study was to determine the association between maternal age and different newborn health parameters. An observational study was conducted in Spain on primiparous women and their infants. Data were collected on newborn health variables, breastfeeding, and different clinical practices that are beneficial for child health and development. Crude and adjusted mean differences were calculated along with the standard error of the mean. A total of 373 women and their children participated. In terms of early commencement skin-to-skin contact, the mean age of women that did skin-to-skin contact was 29.95 ± 0.31 years compared to 31.49 ± 0.66 years in those that did not (p = 0.042). In terms of other newborn parameters, such as preterm birth, health problems or complications, or the need for hospital admission, these were more frequent in the oldest group of mothers, but the differences found were not significant (p > 0.05). Hence, indicators of newborn morbidity were not found to be significantly associated with maternal age; however, beneficial practices such as early commencement skin-to-skin contact were found to be significantly associated with maternal age.


Assuntos
Saúde do Lactente/estatística & dados numéricos , Idade Materna , Mães/estatística & dados numéricos , Adulto , Fatores Etários , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Avaliação Nutricional , Estado Nutricional , Gravidez , Espanha , Adulto Jovem
15.
Sex Reprod Health Matters ; 27(1): 1599653, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31533570

RESUMO

Panel data from 157 countries, between 1970 and 2007, were used to study the associations between introducing an explicit and enforceable right to health into national constitutions and subsequent reductions in neonatal, infant, and maternal mortality and the probability of dying for adult women. The introduction of a right to health in a national constitution was significantly associated with subsequent reductions in neonatal and infant mortality rates. However, it was not associated with reductions in maternal mortality ratios and the probability of dying for adult women. The reduction in neonatal and infant mortality rates was large in countries with high scores for democratic governance, but approximately half as great in countries with low scores for democratic governance. The results suggest that introducing a constitutional right to health is likely to be an effective mechanism for improving infant health in countries with a high level of democratic governance. This health benefit is not seen in maternal and women's health outcomes. There is an imminent need to translate the constitutional promise of a right to health into the improvement of maternal health for all in the era of the Sustainable Development Goals.


Assuntos
Saúde Materna , Saúde Reprodutiva , Direito à Saúde , Adolescente , Adulto , Feminino , Saúde Global , Humanos , Lactente , Saúde do Lactente , Mortalidade Infantil/tendências , Mortalidade Materna/tendências , Pessoa de Meia-Idade , Análise de Regressão , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-31487782

RESUMO

Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western background, low household income, loss of energy, and maternal psychopathology were significantly associated with worse mental HRQoL (p < 0.05). We identified multiple determinants of suboptimal physical and mental HRQoL after childbirth. In particular, maternal psychopathology after childbirth was profoundly associated with mental HRQoL. These women may need support. We therefore call for awareness among health care professionals.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Saúde do Lactente/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Gravidez/estatística & dados numéricos , Qualidade de Vida/psicologia , Adulto , Feminino , Humanos , Países Baixos , Parto
18.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46768

RESUMO

O objetivo da IBFAN é coordenar esforços de proteção ao aleitamento materno, compartilhar informações e aumentar a consciência mundial sobre a importância da amamentação e os perigos potenciais da alimentação artificial na infância. Ela atua também para sensibilizar as autoridades internacionais (especialmente OMS e UNICEF) e nacionais quanto à implementação do código internacional de comercialização de substitutos do leite materno e das resoluções a ele relacionadas.


Assuntos
Aleitamento Materno , Alimentação Artificial , Saúde do Lactente , Lactente , Alimentos Infantis
19.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46743

RESUMO

O leite materno gera inúmeros benefícios para mãe e filho. Além do valor nutritivo para os bebês, ele protege as crianças contra infecções, alergias, algumas doenças crônicas e cânceres infantis.


Assuntos
Aleitamento Materno , Saúde do Lactente , Leite Humano
20.
Early Hum Dev ; 136: 60-69, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31377564

RESUMO

BACKGROUND: In 1989-1991, a population-based cohort of every Missouri birth weighing < 1500 g was identified over a 16-month period. Infants born moderately low birth weight (MLBW, 1500-2499 g) and normal birth weight (NBW, ≥ 2500 g), were matched to < 1500 g infants by delivery date, race, maternal age, and residence. AIMS: To compare outcomes of extremely low birth weight (ELBW, < 1000 g), very low birth weight (VLBW, 1000-1499 g), and MLBW, to NBW infants at age 10. STUDY DESIGN: A population-based cohort and matched case-control study OUTCOME MEASURES: A Child Health and Development Questionnaire developed for this study collected social, medical, educational and special services history. The Conners' Parent Rating Scale-Revised was also completed by parents/caregivers. RESULTS: As birth weight declined, the prevalence of adverse outcomes increased. Children in all LBW groups were more likely than NBW children to have problems in speech and language, vision, fine and gross motor tasks, illnesses, attention, school performance, and increased requirements for therapy and accommodation. Repetition of a grade was three times higher for MLBW children and over three times higher for the other LBW groups. CONCLUSION: In this statewide population-based study, controlling for child's sex, mother's age, race, residence, education, marital status, Medicaid assistance, and smoking or alcohol use during pregnancy, failed to eliminate the strong effect of decreasing birth weight. Problems were most frequent in ELBW, however, VLBW and MLBW also had many significantly greater problems than NBW children. All LBW groups of children experienced greater adverse health and developmental outcomes resulting in significant habilitation and educational challenges.


Assuntos
Deficiências do Desenvolvimento/epidemiologia , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Sucesso Acadêmico , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Lactente , Saúde do Lactente/estatística & dados numéricos , Recém-Nascido , Masculino , Idade Materna , Missouri , Fatores Socioeconômicos
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