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1.
BMC Public Health ; 21(1): 1758, 2021 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-34565370

RESUMO

BACKGROUND: Breastfeeding for optimum duration is one of the most effective ways to reduce infant morbidity and mortality and confirms expected growth and development of children. The aim of this study was to determine the effect of socio-demographic and anthropometric determinants on duration of breastfeeding (DB) among mothers in Bangladesh. METHODS: The data was extracted from the Bangladesh Demographic and Health Survey (BDHS)-2014. A total of 3541 married non-pregnant and currently non-breastfeeding Bangladeshi mothers in reproductive age who had at least one child aged 6-36 months were included in this study. Independent sample t-test and one-way analysis of variance (ANOVA) were used to find the significance difference in DB between two and more than two groups respectively. Multiple linear regression model was utilized to determine the effect of socio-economic, demographic, anthropometric and health related variables on DB. RESULTS: This study revealed that the mean and median of DB among Bangladeshi mothers were 18.91 (95% CI: 18.65-19.17) and 19.00 months respectively. Independent sample t-test and ANOVA showed that DB among Bangladeshi mothers was significantly influenced by (i) ANC visits, (ii) religion, (iii) mode of delivery, (iv) place of delivery, (v) parents' education, (vi) geographical location, (vii) mothers' occupation and (viii) household wealth quintile. Multiple regression analysis demonstrated that mothers' age, total number of children, mothers' age at first birth, ANC visits, mothers' occupation and geographical location were important predictors of DB. CONCLUSIONS: Healthcare providers and decision makers can consider these findings to make plan for counseling of mothers and family members to promote optimum DB practice in first 2 years of baby's life.


Assuntos
Aleitamento Materno , Mães , Bangladesh/epidemiologia , Ordem de Nascimento , Criança , Feminino , Humanos , Lactente , Fatores Socioeconômicos
2.
Nutrients ; 13(9)2021 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-34578895

RESUMO

Worldwide, ten and a half million children under five die every year, with 98% of these deaths in low- and middle-income countries, including Ethiopia. Undernutrition is a serious public health problem in Ethiopia and children are the most affected segments of the population. This study, therefore, sought to investigate the socio-economic, demographic, health and environmental factors associated with undernutrition among children aged 6-59 months in Ethiopia. Data were obtained from the 2016 Ethiopian Demographic and Health Survey. In this study, anthropometric data (height and weight) and other variables of 9461 children were measured. Descriptive statistics and multilevel logistic regression models were fitted. The descriptive results revealed that about 27.5% of the children aged between 6-59 months were undernourished. Place of residence, employment status of the mother, educational status of the mother, the mother's nutritional status, age of the child, birth order of children, source of drinking water, diarrhea and fever among children in the two weeks before the survey were the most important factors associated with undernutrition among children aged 6-59 months in Ethiopia. The findings indicate that it is useful to support health care and food security programs in rural areas to directly address food insecurity and undernutrition problems of the poor and exposed communities in rural parts of the country. The education sector must increase mothers' access to education in all areas to help identify the quality of healthcare and the required attention needed for their children. The health sector should increase their health education programs on the importance of exclusive breastfeeding.


Assuntos
Características da Família , Nível de Saúde , Desnutrição/epidemiologia , Estado Nutricional , Fatores Etários , Ordem de Nascimento , Pré-Escolar , Escolaridade , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Mães/estatística & dados numéricos , Características de Residência , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Abastecimento de Água/estatística & dados numéricos
3.
BMC Womens Health ; 21(1): 278, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34340658

RESUMO

INTRODUCTION: The first birth is the most significant events in a woman's life that indicates the beginning of undertaking the intensive responsibilities of motherhood and childcare. Age at first birth has health, economic and social consequences and implications. But little has been known on the time to first birth and its determinants in Ethiopia. Therefore, this research is planned to address this issue. OBJECTIVES OF THE STUDY: To assess the time to first birth and its determinants among married female youths in Ethiopia, 2020. METHODS: The data was accessed freely through ( https://www.dhsprogram.com ). Survival analysis of time to first birth was done based on EDHS 2016 data among 2597 weighted study subjects. The data was extracted using STATA version 14.0. Kaplan Meier's survival and Log rank test were used to compare survival experiences of respondents using categorical variables. Proportional hazard assumption was checked and was not violated. Cox proportional hazard model was applied, hazard ratio with 95% CI was computed and variables with p value < 0.05 in the multivariable analysis were taken as significant determinants. RESULTS: Overall median survival time was 18 years (IQR = 17-20). The significant determinants of time to first birth are place of residence (being rural (AHR = 1.49, 95% CI 1.13, 1.97),Religion (being Muslim [AHR = 1.57, 95% CI 1.22, 2.02),being protestant (AHR = 1.73, 95% CI 1.34, 2.24)], age at first sex [first sex < 15 years (AHR = 1.68, 95% CI 1.23, 2.29)] and first sex between 15 and 17 years (AHR = 1.54, 95% CI 1.29, 1.85), age at first marriage (marriage < 15 years (AHR = 6.52, 95% CI 4.91, 8.64), marriage between 15 and 17 (AHR = 2.63, 95% CI 2.20, 3.14), unmet need for family planning (AHR = 1.23, 95% CI 1.00, 1.52) CONCLUSION: In this study, the median age at first birth was 18 years. This show, about 50% of study participants give birth for the first time before their 18th birth day. This age is the ideal age for schooling and to do other personal development activities. Therefore giving birth before 18 year will limit female youths from attending school and performing personal development activities in addition to health and demographic consequences of early child bearing.


Assuntos
Ordem de Nascimento , Serviços de Planejamento Familiar , Adolescente , Escolaridade , Etiópia , Feminino , Humanos , Gravidez , Modelos de Riscos Proporcionais
4.
BMJ Open ; 11(8): e045795, 2021 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-34426461

RESUMO

INTRODUCTION: The hygiene hypothesis suggests that reduced exposure to microbes might have contributed to the increase in prevalence and incidence of asthma and allergy observed during the second half of the last century. Following this proposal, several studies have investigated the role of sibship size and birth order in the development of asthma and allergic diseases, but the underlying evidence is conflicting. The objective of the present systematic review will be to identify, critically appraise and synthesise previous primary studies investigating the association of sibship size and birth order with the risk of asthma and allergic diseases. METHODS AND ANALYSIS: The following databases will be searched: AMED, CABI, CINAHL, Embase, Google Scholar, OAIster, Open Access Theses and Dissertations, Open Grey, ProQuest Dissertations & Theses Global, PsycINFO, PubMed, SciELO, Scopus, Web of Science and WHO Global Index Medicus. Studies published up until 31 December 2020 will be eligible. There will be no restrictions by language and geographical location. Risk of bias in the included studies will be assessed using the Effective Public Health Practice Project quality assessment tool. The produced evidence will be synthesised narratively, and studies that present comparable numerical data will be included in meta-analyses using random effects model. ETHICS AND DISSEMINATION: Only data from the published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020207905.


Assuntos
Asma , Hipersensibilidade , Asma/epidemiologia , Asma/etiologia , Ordem de Nascimento , Humanos , Hipersensibilidade/epidemiologia , Metanálise como Assunto , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
5.
Arch Sex Behav ; 50(6): 2395-2409, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34417640

RESUMO

Birth order may foster specific roles for individuals within the family and set in train a dynamic that influences the development of specific behaviors. In this paper, we explored the relationship between birth order, sex, timing of sexual initiation, and its consequences for risky sexual behavior and sexual health. We conducted a path analysis to simultaneously estimate direct and indirect effects using data from the National Survey of Sexual Attitudes and Lifestyles (NATSAL-3). Whereas women born as only-children were more likely to sexually debut at later ages, middle-child boys were significantly more prone to initiate sexual intercourse earlier compared with first-borns. As expected, early sexual initiation was associated with riskier behaviors and sexual health outcomes. These associations were partially moderated by siblings role as confidants about sexuality. Our findings have implications for preventive programs aimed at promoting healthy sexual debuts and behaviors over the life span.


Assuntos
Comportamento do Adolescente , Irmãos , Adolescente , Ordem de Nascimento , Feminino , Humanos , Masculino , Assunção de Riscos , Comportamento Sexual
6.
J Stud Alcohol Drugs ; 82(4): 470-475, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34343078

RESUMO

OBJECTIVE: The aims of this brief report were to examine the extent to which early onset of cannabis use by parents and their children, and intergenerational continuity in early-onset cannabis use by parents and children, differ as a function of parent age at birth of first child. METHOD: A total of 795 parent-child dyads (57% male parents and 49% male children) were compiled from three intergenerational studies: Oregon Youth Study-Three Generational Study (OYS-3GS), Rochester Youth Development Study and Rochester Intergenerational Study (RYDS-RIGS), and Seattle Social Development Project-The Intergenerational Project (SSDP-TIP). Parents and children identified as non-Hispanic White (29% and 22%, respectively), Black (55% and 47%), and Hispanic (8% and 11%). Early-onset cannabis use was defined as initiation at or before age 15. Time-varying effect models were fit to examine the research questions. RESULTS: Among parents, earlier initiation of cannabis use was associated with an earlier entry into parenthood. Moreover, parents' later age at first birth was predictive of a lower prevalence of early-onset cannabis use among their children. Last, regarding intergenerational continuity, parental early onset of cannabis use increased the likelihood of child early-onset use, but only among older parents (i.e., later age at first birth). CONCLUSIONS: We provide a nuanced examination of the associations between parental and child early-onset cannabis use as a function of parents' age at first birth and describe a novel approach to incorporating parent's age at first birth into models of intergenerational continuity.


Assuntos
Cannabis , Adolescente , Ordem de Nascimento , Hispano-Americanos , Humanos , Recém-Nascido , Oregon , Pais
7.
Drug Alcohol Depend ; 226: 108859, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34198139

RESUMO

BACKGROUND: Previous studies have found that birth order is an important predictor of later life health, including hospitalisation for alcohol use. We examine the relationship between birth order and alcohol-related mortality in two national contexts, within native families who differ on ethnic origin. METHODS: We study the association between birth order and alcohol-related mortality after age 17, using Finnish register data for cohorts born 1953-1999 and Swedish register data for cohorts born 1940-1999. We apply Cox proportional hazard models and use sibling fixed effects that eliminate confounding by factors shared by siblings. We separate full-sibling groups by ethnic origin, which for Finland means mother's and father's Finnish or Swedish ethnolinguistic affiliation. For Sweden, we distinguish native-born according to whether one or both parents were born in Sweden or Finland. RESULTS: We find a positive correlation between birth order and alcohol-related mortality, but only for ethnic Finns in Finland and primarily men. Within these sibling groups, second-borns have an alcohol-related mortality risk that is 9% higher than that of first-borns, third-borns 19 % higher, fourth-borns 22 % higher, and fifth- or higher-borns 47 % higher. No such birth order associations can be found for any of the other ethnic groups analysed in Finland or Sweden. CONCLUSIONS: Our findings suggest that cultural-related behaviours typical for ethnic groups, and the national context in which they are studied, are relevant for whether any association between birth order and alcohol-related mortality can be observed. Differences in the social interplay within the family may be an important factor.


Assuntos
Ordem de Nascimento , Grupos Étnicos , Adolescente , Finlândia/epidemiologia , Humanos , Masculino , Irmãos , Suécia/epidemiologia
8.
Hum Nat ; 32(2): 387-405, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34228304

RESUMO

Namesaking (naming a child after a parent or other relative) can be viewed as a mechanism to increase perceived parent-child similarity and, consequently, parental investment. Male and, to a lesser extent, firstborn children are more frequently namesakes than female and later-born children, respectively. However, a direct link between namesaking and parental investment has not been examined. In the present study, 632 participants (98 men and 534 women) from Central Europe indicated their first name, sex, birth order, number of siblings, sexual orientation, socioeconomic status, paternal and maternal first names, as well as relationship quality with, and time and financial investment they received from, both parents during childhood. Mixed-effects models revealed associations between namesaking and parental investment. However, the effect of namesaking often appeared significant only in interaction with specific predictors, such as sex and primogeniture. It suggests instead that namesaking has an additive effect-it enhances the effect of biological factors on parental investment. In general, we found evidence for the bias in parental investment linked to name similarity among both parents, and support for the hypothesis that namesaking serves as a mechanism to increase paternity confidence and, thus, paternal investment. The effect of namesaking influences only certain types of parental investment-namely, those at the level of relationship quality. In addition, nonheterosexual orientation was the strongest negative predictor of paternal investment. Our study extends the research on parental investment by showing that cultural mechanisms, such as namesaking, can also exert some influence on parental rearing behavior.


Assuntos
Pai , Pais , Ordem de Nascimento , Relações Familiares , Feminino , Humanos , Masculino , Paternidade
9.
Infant Behav Dev ; 64: 101608, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34265513

RESUMO

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.


Assuntos
Ordem de Nascimento , Família , Criança , Pré-Escolar , Escolaridade , Humanos , Estudos Longitudinais , Masculino , Idade Materna
10.
BMC Pregnancy Childbirth ; 21(1): 468, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193067

RESUMO

BACKGROUND: Early initiation of breastfeeding (EIBF), breastfeeding within first hour after birth, is known to have major benefits for both the mother and newborn. EIBF rates, however, tends to vary between and within countries. This study set out to determine the prevalence of EIBF at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana, and to evaluate the determinants of EIBF and time to initiation of breastfeeding. METHODS: A cross-sectional study was conducted at the KATH postnatal wards between August and October 2014. Three hundred and eighty-two mothers delivering at KATH were recruited and data on time to initiation of breastfeeding, antenatal, delivery and immediate postnatal periods were collected. Data analyses using both binary and ordinal logistic regressions with stepwise elimination were used to determine the relationship between EIBF and time to initiation of breastfeeding on one side, and the maternal, pregnancy, delivery and neonatal associated factors. RESULTS: EIBF was done in 39.4% (95%CI: 34.3-44.5) of the newborns with breastfeeding initiated between 1 to 6 h for 19.7%, 6 to 11 h in 4.8%, 11 to 16 h in 4.8% and after 16 h in 28.5% of the deliveries. A higher number of antenatal care visits (AOR = 1.14, 95%CI: 1.04-1.25, p = 0.006), delivery by caesarean section (AOR = 0.07, 95%CI: 0.01-0.79, p = 0.031) and infant rooming-in with mother (AOR: 31.67, 95%CI: 5.59-179.43, p <  0.001) were significantly and independently associated with EIBF. Factors independently associated with longer time to initiation of breastfeeding were older maternal age (AOR = 1.04, 95%CI: 1.00-1.09, p = 0.039), Akan ethnicity (AOR = 1.92, 95%CI: 1.14-3.22, p = 0.014), first-born child (AOR = 2.06, 95%CI: 1.18-3.58, p = 0.011), mother rooming-in with newborn (AOR = 0.01. 95%CI: 0.00-0.02, p <  0.001), increasing fifth minute APGAR score (AOR = 0.73, 95%CI: 0.58-0.93, p = 0.010) and using prelacteals (AOR = 2.42, 95%CI: 1.34-4.40, p = 0.004). CONCLUSIONS: The low EIBF rate and prolonged time to initiation of breastfeeding at a major tertiary health facility is a major concern. Key interventions will need to be implemented at KATH and possibly other tertiary healthcare facilities in Ghana and beyond to improve EIBF rate and time to breastfeeding.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Ordem de Nascimento , Estudos Transversais , Parto Obstétrico/estatística & dados numéricos , Feminino , Gana , Inquéritos Epidemiológicos , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Idade Materna , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Fatores Socioeconômicos , Fatores de Tempo , Adulto Jovem
11.
Andes Pediatr ; 92(1): 79-85, 2021 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34106186

RESUMO

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.


Assuntos
Proteínas na Dieta/administração & dosagem , Fidelidade a Diretrizes , Recomendações Nutricionais , Fatores Etários , Análise de Variância , Animais , Ordem de Nascimento , Aleitamento Materno/estatística & dados numéricos , Distribuição de Qui-Quadrado , Feminino , Peixes , Humanos , Lactente , Fórmulas Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Carne , Aves Domésticas , Fatores de Tempo , Verduras
12.
PLoS One ; 16(6): e0253736, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34191843

RESUMO

BACKGROUND: In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. METHOD: This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. RESULT: According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women's residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth (<18), narrow birth intervals, and high birth orders were HRFBs associated with an increased occurrences of child stunting and anemia. CONCLUSION: This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition.


Assuntos
Anemia/epidemiologia , Transtornos do Crescimento/epidemiologia , Comportamento Reprodutivo/estatística & dados numéricos , Assunção de Riscos , Adolescente , Adulto , África Oriental/epidemiologia , Fatores Etários , Intervalo entre Nascimentos/psicologia , Intervalo entre Nascimentos/estatística & dados numéricos , Ordem de Nascimento , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Idade Materna , Pessoa de Meia-Idade , Estado Nutricional , Gravidez , Comportamento Reprodutivo/psicologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
13.
BMC Pregnancy Childbirth ; 21(1): 344, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933011

RESUMO

BACKGROUND: Maternal age < 18 or > 34 years, short inter-pregnancy birth interval, and higher birth order are considered to be high-risk fertility behaviours (HRFB). Underfive mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and underfive mortality in selected Asian and African countries. METHODS: This study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in sub-Saharan Africa, Middle East, North Africa and South Asia from 1986 to 2017 (N = 1,467,728). Previous evidence hints at four markers of HRFB: women's age at birth of index child < 18 or > 34 years, preceding birth interval < 24 months and child's birth order > 3. Using logistic regression, we analysed change in the odds of underfive mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors. RESULTS: Mother's age at birth of index child < 18 years and preceding birth interval (PBI) < 24 months were significant risk factors of underfive mortality, while a child's birth order > 3 was a protective factor. Presence of any single HRFB was associated with 7% higher risk of underfive mortality (OR 1.07; 95% CI 1.04-1.09). Presence of multiple HRFBs was associated with 39% higher risk of underfive mortality (OR 1.39; 95% CI 1.36-1.43). Some specific combinations of HRFB such as maternal age < 18 years and preceding birth interval < 24 month significantly increased the odds of underfive mortality (OR 2.07; 95% CI 1.88-2.28). CONCLUSION: Maternal age < 18 years and short preceding birth interval significantly increase the risk of underfive mortality. This highlights the need for an effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for optimal birth spacing.


Assuntos
Intervalo entre Nascimentos/estatística & dados numéricos , Ordem de Nascimento , Fertilidade , Mortalidade Infantil/tendências , Idade Materna , Adolescente , Adulto , África , Ásia , Pré-Escolar , Países em Desenvolvimento , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
15.
Allergol Immunopathol (Madr) ; 49(3): 146-152, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33938200

RESUMO

INTRODUCTION AND OBJECTIVES: In order to investigate food allergy's prevalence, risk factors and eating behavior of children with relevant anamnesis, a study was performed in Cypriot primary schools. PATIENTS: A specially composed questionnaire for self-reported adverse reactions to food, created in the context of the EuroPrevall study, was distributed in 13 representative primary schools across the country. Participants were sub-grouped into three groups; healthy (H), those with unconfirmed food hypersensitivity reactions (FA-) and children with a confirmed diagnosis by a physician IgE-mediated food allergy (FA+). Food habits, family health history and lifestyle factors were assessed and groups' outcomes were compared with each other. RESULTS: For the study, 202 questionnaires were completed and returned; 31 children (19 FA- and 12 FA+) reported an adverse food reaction. Significant risk factors for developing FA+ were being the first born or having siblings with asthma, attended a day nursery, but also maternal alcohol drinking during pregnancy, parental smoking and parental occupation in food processing or use of latex gloves. The presence of children in the kitchen during cooking showed a protective role. Dietary habits of FA+ children were significantly diminished in terms of variety and frequency of consumption in comparison to the rest, in which had a greater overlap. CONCLUSION: Further research is required for the interesting risk or protective factors revealing from the current investigation. The negative effect of food allergy in the dietary habits of food allergic children documented in the literature, is strongly supported herein.


Assuntos
Comportamento Alimentar , Hipersensibilidade Alimentar/etiologia , Alimentos/efeitos adversos , Consumo de Bebidas Alcoólicas , Ordem de Nascimento , Criança , Pré-Escolar , Culinária , Chipre/epidemiologia , Saúde da Família , Feminino , Manipulação de Alimentos , Hipersensibilidade Alimentar/epidemiologia , Humanos , Imunoglobulina E/imunologia , Hipersensibilidade ao Látex , Estilo de Vida , Masculino , Mães , Gravidez , Prevalência , Fatores de Risco , Escolas Maternais , Autorrelato/estatística & dados numéricos , Irmãos , Fumar
16.
PLoS One ; 16(4): e0249978, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33891603

RESUMO

BACKGROUND: Anemia is a major public health problem affecting more than half of children under the age of five globally. It has serious short- and long-term consequences including growth retardation, impaired motor and cognitive development, and increased morbidity and mortality. Despite anemia is the leading cause of child mortality in sub-Saharan Africa, there is limited evidence on the prevalence and determinants of anemia among under-five children in sub-Saharan Africa. Therefore, this study aimed to investigate the prevalence and determinants of severity levels of anemia among children aged 6-59 months in sub-Saharan Africa. METHODS: This study was based on the most recent Demographic and Health Survey (DHS) data of 32 sub-Saharan African countries. A total weighted sample of 135,619 children aged 6-59 months was included in the study. Considering the hierarchical nature of DHS data and the ordinal nature of anemia, a multilevel ordinal logistic regression model was applied. Proportional odds assumption was tested by Brant test and it was satisfied (p-value = 0.091). Besides, deviance was used for model comparison. Variables with a p-value ≤0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel proportional odds model, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported for potential determinant factors of severity levels of anemia. RESULTS: The overall prevalence of anemia among children aged 6-59 months in sub-Saharan Africa was 64.1% [95% CI: 63.9%, 64.4%]. Of which, 26.2% were mildly anemic, 34.9% moderately anemic and 3% severely anemic. Poor maternal education, lower household wealth status, large family size, being male child, multiple births, having fever in the last two weeks, having diarrhea in the last two weeks, higher-order birth, maternal anemia, underweight, wasted, and stunted were significantly associated with increased odds of higher levels of anemia. Whereas, being 24-59 months age, taking drugs for an intestinal parasite, and born from mothers aged ≥ 20 years were significantly associated with lower odds of higher levels of anemia. CONCLUSION: Severity levels of anemia among children aged 6-59 months in sub-Saharan Africa was a major public health problem. Enhancing maternal education, providing drugs for an intestinal parasite, designing interventions that address maternal anemia, febrile illness, and diarrheal disease, and strengthening the economic status of the family are recommended to reduce childhood anemia. Furthermore, it is better to strengthen the strategies of early detection and management of stunted, wasted, and underweight children to decrease childhood anemia.


Assuntos
Anemia/patologia , Índice de Gravidade de Doença , África ao Sul do Saara/epidemiologia , Anemia/epidemiologia , Ordem de Nascimento , Pré-Escolar , Escolaridade , Características da Família , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Modelos Logísticos , Masculino , Mães/estatística & dados numéricos , Razão de Chances , Pobreza , Prevalência , Fatores Sexuais , Magreza
17.
Cancer Causes Control ; 32(7): 713-723, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33877514

RESUMO

PURPOSE: Initial genetic alterations in the development of childhood leukemia occur in utero or before conception; both genetic and environmental factors are suspected to play a role. We aimed to investigate the associations between childhood leukemia and perinatal characteristics including birth order, birth interval to older siblings, parental age, birth weight, and multiple birth. METHODS: We identified cases diagnosed between 1981 and 2015 and born in Switzerland between 1969 and 2015 from the Swiss Childhood Cancer Registry and randomly sampled five controls per case from national birth records matched on date of birth, sex, and municipality of residence at birth. We used conditional logistic regression to investigate associations between perinatal characteristics and leukemia at ages 0-15 and 0-4 years, and the subtypes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). RESULTS: The study included 1,403 cases of leukemia. We observed increased risks associated with high birth weight (adjusted OR 1.37, 95% CI 1.12-1.69) and multiple birth (1.89, 1.24-2.86). These associations were similar for ALL and stronger for leukemia at ages 0-4 years. For AML, we observed an increased risk for higher birth order (3.08, 0.43-22.03 for fourth or later born children). We found no associations with other perinatal characteristics. CONCLUSION: This register-based case-control study adds to the existing evidence of a positive association between high birth weight and risk of childhood leukemia. Furthermore, it suggests children from multiple births are at an increased risk of leukemia.


Assuntos
Ordem de Nascimento , Peso ao Nascer , Leucemia Mieloide Aguda/epidemiologia , Prole de Múltiplos Nascimentos , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Leucemia Mieloide Aguda/etiologia , Modelos Logísticos , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologia , Modelos de Riscos Proporcionais , Sistema de Registros , Medição de Risco , Fatores de Risco , Suíça/epidemiologia
19.
Natl Vital Stat Rep ; 70(2): 1-51, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33814033

RESUMO

Objectives-This report presents 2019 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods-Descriptive tabulations of data reported on the birth certificates of the 3.75 million births that occurred in 2019 are presented. Data are presented for maternal age, livebirth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality. Selected data by mother's state of residence and birth rates by age are also shown. Trend data for 2010 through 2019 are presented for selected items. Trend data by race and Hispanic origin are shown for 2016-2019. Results-A total of 3,747,540 births were registered in the United States in 2019, down 1% from 2018. The general fertility rate declined from 2018 to 58.3 births per 1,000 women aged 15-44 in 2019. The birth rate for females aged 15-19 fell 4% between 2018 and 2019. Birth rates declined for women aged 20-34 and increased for women aged 35-44 for 2018-2019. The total fertility rate declined to 1,706.0 births per 1,000 women in 2019. Birth rates declined for both married and unmarried women from 2018 to 2019. The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.6% in 2019; the percentage of all women who smoked during pregnancy declined to 6.0%. The cesarean delivery rate decreased to 31.7% in 2019 (Figure 1). Medicaid was the source of payment for 42.1% of all births in 2019. The preterm birth rate rose for the fifth straight year to 10.23% in 2019; the rate of low birthweight was essentially unchanged from 2018 at 8.31%. Twin and triplet and higher-order multiple birth rates both declined in 2019 compared with 2018.


Assuntos
Coeficiente de Natalidade/tendências , Adolescente , Adulto , Declaração de Nascimento , Ordem de Nascimento , Coeficiente de Natalidade/etnologia , Peso ao Nascer , Grupos de Populações Continentais/estatística & dados numéricos , Parto Obstétrico/economia , Parto Obstétrico/métodos , Feminino , Idade Gestacional , Hispano-Americanos/estatística & dados numéricos , Humanos , Recém-Nascido , Masculino , Estado Civil/etnologia , Estado Civil/estatística & dados numéricos , Idade Materna , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Prole de Múltiplos Nascimentos/estatística & dados numéricos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Uso de Tabaco/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
20.
BMC Womens Health ; 21(1): 113, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33740957

RESUMO

BACKGROUND: High maternal and child death with high fertility rate have been reported in Ethiopia. Extreme age at first birth is linked with both maternal and child morbidity and mortality. However, literatures showed there were limited studies on the timing of the first birth and its predictors in the area so far. Therefore, determining the time to first birth and its predictors will help to design strategies to improve maternal and child survival. METHODS: A community-based cross-sectional study was conducted among reproductive-age women in Ethiopia using the Ethiopian demographic health survey, 2016 data. Stratified two-stage cluster sampling technique was used for sampling. The Kaplan-Meier method was used to estimate time to first birth. Inverse Weibull gamma shared frailty model applied to model the data at 95% confidence interval (CI), adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Proportional hazard assumption checked using Schoenfeld residual test. Information Criteria were applied to select a parsimonious model. Stratified analysis performed for the interaction terms and statistical significance was declared at p value < 0.05. RESULTS: The overall median age at first birth was found to be 20 years (IQR, 16-24 years). The independent predictors of time to first birth were: married 15-17 years (AHR = 2.33, 95% CI 2.08-2.63), secondary education level (AHR = 0.84, 95% CI 0.78-0.96), higher education level (AHR = 0.75, 95% CI 0.65-0.85), intercourse before 15 years in the married stratum (AHR = 23.81, 95% CI 22.22-25.64), intercourse 15-17 years in married stratum (AHR = 5.56, 95% CI 5.26-5.88), spousal age difference (AHR = 1.11, 95% CI 1.05-1.16),and use of contraceptives (AHR = 0.91, 95% CI 0.86-0.97). The median increase in the hazard of early childbirth in a cluster with higher early childbirth is 16% (MHR = 1.16, 95% CI 1.13-1.20) than low risk clusters adjusting for other factors. CONCLUSION: In this study, first birth was found to be at an early age. Early age at first marriage, at first sexual intercourse and their interaction, high spousal age difference, being Muslim were found to increase early motherhood. Conversely, living in the most urban region, secondary and higher women education were identified to delay the first birth. Investing on women education and protecting them from early marriage is required to optimize time to first birth. The contextual differences in time to first birth are an important finding which requires more study and interventions.


Assuntos
Ordem de Nascimento , Fragilidade , Criança , Estudos Transversais , Escolaridade , Etiópia/epidemiologia , Feminino , Humanos , Gravidez
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