Birth Parents Research Articles

Birth Spacing and Parents’ Physical and Mental Health: An Analysis Using Individual and Sibling Fixed Effects

An extensive literature has examined the relationship between birth spacing and subsequent health outcomes for parents, particularly for mothers. However, this research has drawn almost exclusively on observational research designs, and almost all studies have been limited to adjusting for observable factors that could confound the relationship between birth spacing and health outcomes. In this study, we use Norwegian register data to examine the relationship between birth spacing and the number of general practitioner consultations for mothers’ and fathers’ physical and mental health concerns immediately after childbirth (1–5 and 6–11 months after childbirth), in the medium term (5–6 years after childbearing), and in the long term (10–11 years after childbearing). To examine short-term health outcomes, we estimate individual fixed-effects models: we hold constant factors that could influence parents’ birth spacing behavior and their health, comparing health outcomes after different births to the same parent. We apply sibling fixed effects in our analysis of medium- and long-term outcomes, holding constant mothers’ and fathers’ family backgrounds. The results from our analyses that do not apply individual or sibling fixed effects are consistent with much of the previous literature: shorter and longer birth intervals are associated with worse health outcomes than birth intervals of approximately 2–3 years. Estimates from individual fixed-effects models suggest that particularly short intervals have a modest negative effect on maternal mental health in the short term, with more ambiguous evidence that particularly short or long intervals might modestly influence short-, medium-, and long-term physical health outcomes. Overall, these results are consistent with small to negligible effects of birth spacing behavior on (non-pregnancy-related) parental health outcomes.

Prospective cohort study of genomic newborn screening: BabyScreen+ pilot study protocol

IntroductionNewborn bloodspot screening (NBS) is a highly successful public health programme that uses biochemical and other assays to screen for severe but treatable childhood-onset conditions. Introducing genomic sequencing into NBS...

A qualitative exploration of adoptive family practices in contemporary India: the voices of adoptees of closed adoptions

Drawing on an empirical narrative research study, this article illuminates the lived experiences of Indian adoptees of closed adoptions, that is, those who had no contact with their birth parents in the run-up to or following adoption. The findings of five in-depth accounts comprising young adult and adult adoptees present a deep and nuanced understanding of what remains a relatively unexplored area of adoptive family lives in contemporary India practised in an environment where the intricacies of culture and notions of biological ties are privileged over social ties. This article illustrates how the way adoption stories are lived, experienced and shaped contributes to adoptees’ understandings of how to navigate the challenges to confirm their membership in their adoptive families in a situation where these relationships fall under constant suspicion, denial and disapproval. While it is accepted that this non-representative sample cannot reflect wider perspectives of adoptive lives, it nevertheless highlights the inherent complexities and provides a useful springboard for further research.

Prenatal polycyclic aromatic hydrocarbon exposure and asthma at age 8–9 years in a multi-site longitudinal study

Background and aimStudies suggest prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) may influence wheezing or asthma in preschool-aged children. However, the impact of prenatal PAH exposure on asthma and wheeze in middle childhood remain unclear. We investigated these associations in socio-demographically diverse participants from the ECHO PATHWAYS multi-cohort consortium.MethodsWe included 1,081 birth parent–child dyads across five U.S. cities. Maternal urinary mono-hydroxylated PAH metabolite concentrations (OH-PAH) were measured during mid-pregnancy. Asthma at age 8–9 years and wheezing trajectory across childhood were characterized by caregiver reported asthma diagnosis and asthma/wheeze symptoms. We used logistic and multinomial regression to estimate odds ratios of asthma and childhood wheezing trajectories associated with five individual OH-PAHs, adjusting for urine specific gravity, various maternal and child characteristics, study site, prenatal and postnatal smoke exposure, and birth year and season in single metabolite and mutually adjusted models. We used multiplicative interaction terms to evaluate effect modification by child sex and explored OH-PAH mixture effects through Weighted Quantile Sum regression.ResultsThe prevalence of asthma in the study population was 10%. We found limited evidence of adverse associations between pregnancy OH-PAH concentrations and asthma or wheezing trajectories. We observed adverse associations between 1/9-hydroxyphenanthrene and asthma and persistent wheeze among girls, and evidence of inverse associations with asthma for 1-hydroxynathpthalene, which was stronger among boys, though tests for effect modification by child sex were not statistically significant.ConclusionsIn a large, multi-site cohort, we did not find strong evidence of an association between prenatal exposure to PAHs and child asthma at age 8–9 years, though some adverse associations were observed among girls.

Tuberculosis among children visiting friends & relatives.

Most paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR. We conducted a prospective multicentric observational study in Catalonia (Spain) from June 2017 to December 2019. We enrolled children aged < 15years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent's birth country for ≥21days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8-12weeks post-return. LTBI was defined as a TST ≥5mm and/or a positive QFT-Plus. Five hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU, 95%CI = 8.8-28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3-9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU, 95%CI = 3.9-20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1-13.3). The risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.

Parental involvement and education outcomes of their children

ABSTRACT This study investigates the impact of parental involvement on the education outcomes of their children, specifically focusing on the completion of high school. It extends the existing literature by considering the characteristics of both children and parents, and by examining non-school-related parental involvement in a child’s everyday life. The analysis utilizes a publicly available database, the National Longitudinal Survey of Youth 1997, with a sample of American respondents born between 1983 and 1984 who lived with both birth parents during their early teenage years. The study employs simple logistic regression and subclassification on propensity score to estimate causal treatment effects. The results indicate that higher parental involvement is associated with an increased probability of high school graduation, while stricter parental behaviour is found to decrease the expected likelihood of completing high school.

Gendered transitions to self-employment and business ownership: a linked-lives perspective

ABSTRACT We apply the sociological lens of linked lives to show how household contexts channel transitions to self-employment in ways strongly differentiated by gender. We investigate the impact of demographic transitions to marriage, cohabitation and having children on the transition to self-employment using fixed-effects models on 10 waves of the UK’s nationally representative survey, Understanding Society. Men’s transitions to self-employment and separately to business ownership are remarkably impervious to the arrival of a new child in the household. In contrast, second births raise the odds of self-employment for women and have a strong and statistically significant association with business ownership, highlighting the role of birth parity as a household influence. Within the subset of opposite-sex couples, lives are indeed linked: a partner’s long hours precipitate the other partner’s transition into self-employment for men and women. However, the effect is asymmetric to the extent that women are much more likely to have a partner working long hours. Marriage is associated with a much higher likelihood of transitioning to business ownership for both men and women, which does not hold for self-employment overall.

Intergenerational relationship between parental famine exposure and offspring’s obesity risks

BackgroundThe intergenerational relationship between parental famine exposure and the obesity risks of offspring has not been well studied.MethodsUsing a cohort of 3654 respondents whose parents were born between 1950 and...

“There’s so much history”: shared parenting dynamics in kinship families

ABSTRACT Shared parenting, when adults collaborate in childrearing, is a practice of interest for children in out-of-home care. Yet, little is known about its feasibility and outcomes for kinship families who have preexisting relationships with birth parents. This article shares qualitative results from focus groups that explored participants’ experiences and attitudes toward shared parenting. The sample comprised 25 kinship caregivers and 34 child welfare professionals. Findings revealed that shared parenting within kinship families is often less feasible than desired. This article identifies barriers and facilitators of shared parenting, offers a shared parenting typology, and explores implications for policy and practice.

The Role of African Spirituality in the Provision of Kinship Care in the South African Context

This article focuses on understanding the role played by African spirituality in the provision of kinship care in the South African context. African traditional spirituality was found to be an important factor underpinning kinship care and its provision, especially in rural African communities. The study was conducted using a qualitative research methodology. Twenty-one (21) participants, who were kinship caregivers, were recruited using purposive non-probability sampling methods. The study found that African spirituality helped them to preserve both their cultural and personal identity. Furthermore, through African spirituality, children and youth in kinship care receive psychosocial support and experienced a positive upbringing through their kinship caregivers and tribal community. African kinship caregivers were found to offer kinship care as a spiritual duty to help children and youth who need care and protection in the absence of their birth parents.

African American Parents’ experience with early childhood mental health and child welfare services: Racism and seeking understanding

BackgroundImpacts of child maltreatment and child welfare involvement on young children are significant and early childhood mental health services are important to reduce risk factors for them. However, racial disparities limit access to mental health services. ObjectiveThe purpose of this study is to understand the experience and perspective of birth parents accessing mental health services for their child welfare-involved toddlers and preschoolers aged 1.5 to 5 years. Specifically, this study seeks to examine racism and service disparities among African American parents. To our knowledge, there is no study examining birth parents’ perspectives on mental health services for young children.Participants & Setting: This study collected original qualitative data using semi-structured interviews. Nine African American participants shared their experiences from February 2018 to November 2019. MethodsQualitative data analysis used a pragmatic realist approach to understand the complex phenomenon of parents’ experience accessing services. NVivo 12 was used for qualitative analysis to help condense themes for the study. Quantitative descriptive analysis using Stata 14.2 provided the sample description. ResultsEquity and understanding was a main theme with three sub-themes; racism, child welfare understanding the family, and mental health provider understanding the family. Participants experienced racism, creating a mistrust of mental health providers and child welfare workers. ConclusionImplications for policy and practice to improve equity and understanding of families in child welfare are discussed. Future research can build on this study by examining how racism impacts service use and how interventions can increase understanding of families using child welfare and mental health services.

Paying for Parenthood: Understanding Parental Leave Policies in Infectious Disease Fellowship.

Many physician trainees plan pregnancy during residency and fellowship. A study of internal medicine program directors (PDs) demonstrated frequent misinterpretation of American Board of Internal Medicine (ABIM) leave policies applied to parental leave. The primary aim was to investigate how infectious disease (ID) PDs interpret current ABIM leave policies. We surveyed 155 ID PDs in an online anonymous questionnaire about knowledge of ABIM leave policies and application toward trainee leaves. Of 155 PDs, 56 (36%) responded to the survey. Nearly 70% incorrectly identified leave limits permitted. A majority mistakenly chose to extend training when a competent fellow was within the allowed duration of leave. PDs reported that the majority of ID trainee maternity/birth parent leaves (60%) were ≤7 weeks and only 7% were ≥12 weeks; 50% of paternity/nonbirth parent leaves were ≤3 weeks. Surveyed ID fellowship PDs often misinterpret ABIM leave policies and apply policies incorrectly when given sample scenarios..

Risk factors of malnutrition in children with congenital heart disease: a meta-analysis.

The associated factors of malnutrition in children with congenital heart disease (CHD) must be evaluated to provide evidence for the treatment and care of such children. Two investigators searched the PubMed database until 25 June 2023 for literature about the associated factors of malnutrition in children with CHD. A meta-analysis of associated factors of malnutrition was performed by RevMan 5.3 software. Thirteen studies involving 8,031 children with CHD were included. Pulmonary hypertension (OR = 3.81, 95% CI: 2.46-4.12), low birth weight (OR = 2.69, 95% CI: 1.25-5.77) and parents' height (OR = 2.15, 95% CI: 1.89-2.92) were the associated factors of growth retardation (all P < 0.05). Pulmonary hypertension (OR = 3.77, 95% CI: 3.13-4.24), low birth weight (OR = 3.04, 95% CI: 2.61-4.18) and pneumonia (OR = 2.35, 95% CI: 2.08-2.83) were the associated factors of low body weight of children with CHD (all P < 0.05). Medical staff should fully understand the risk factors, strengthen nutritional support and enhance nursing care for children with CHD to reduce malnutrition.

Sexual and reproductive health outcomes of women who experienced violence in Germany: Analysis of the German health interview and examination survey for adults (DEGS1).

Violence against women is a widespread public health concern with severe effects to women's sexual and reproductive health, including higher risks for miscarriage or stillbirth, unintended pregnancy and induced abortion. This study examined the association between women exposure to physical violence, psychological violence and sexual and reproductive health outcomes (contraceptive use, miscarriage or stillbirth and abortion) in Germany. This study used a cross-sectional research design to analyze data on violence against women and sexual and reproductive health (SRH) outcomes collected through the German Health Interview and Examination Survey for Adults, Wave 1, between 2008 and 2011 (n = 3149 women, aged 18-64 years). Multivariable logistic regression models were used to assess the association between experiences of violence among women and the presence of sexual and reproductive health outcomes, considering the influence of socio-demographic and health-related factors (age, marital status, socioeconomic status, social support, number of children, alcohol consumption, health status, chronic conditions). Three associations remained significant (p<0.05) in fully-adjusted models: (i) exposure to physical violence by a parent or caregiver and birth control pill utilization (aOR, adjusted Odds Ratio, 95% CI: 1.36, 1.02-1.81) (ii) exposure to physical violence since the age of 16 and miscarriage or stillbirth (aOR, 95%CI: 1.89, 1.17-3.04); and (iii) exposure to psychological violence by a parent or caregiver and abortion (aOR, 95%CI: 1.87, 1.30-2.70). The results suggest that adult German women who experienced physical or psychological violence since the age of 16, including violence perpetrated by a parent or caregiver, were more likely to report miscarriage or stillbirth and abortion. Direct assessment of violence experiences against women should be conducted by healthcare professionals in clinical encounters, particularly by obstetrics and gynaecological specialists, for the prevention of women´s adverse sexual and reproductive health outcomes. Furthermore, violence should be treated as a major public health concern and addressed through a multisectoral approach, involving the healthcare and educational sectors, researchers and relevant policymakers.

Impact of early risk factors on schizophrenia risk and age of diagnosis: A Danish population-based register study.

While several risk factors for schizophrenia have been identified, their individual impacts are rather small. The relative independent and cumulative impacts of multiple risk factors on disease risk and age of onset warrant further investigation. We conducted a register-based case-control study including all individuals receiving a schizophrenia spectrum disorder in Denmark from 1973 to 2018 (N=29,142), and a healthy control sample matched 5:1 on age, sex, and parental socioeconomic status (N=136,387). Register data included parental history of psychiatric illness, birth weight, gestational age, season of birth, population density of birthplace, immigration, paternal age, and Apgar scores. Data were analysed using logistic regression and machine learning. Parental history of psychiatric illness (OR=2.32 [95%CI 2.21-2.43]), high paternal age (OR=1.30 [1.16-1.45]), and low birth weight (OR=1.28 [1.16-1.41]) increased the odds of belonging to the patient group. In contrast, being a second-generation immigrant (OR=0.65 [0.61-0.69]) and high population density of the birthplace (OR=0.92 [0.89-0.96]) decreased the odds. The findings were supported by a decision tree analysis where parental history, paternal age, and birth weight contributed most to diagnostic classification (ACCtest=0.69, AUCtest=0.59, p<0.001). Twenty percent of patients were child-onset cases. Here, female sex (OR=1.82 [1.69-1.97]) and parental psychiatric illness (OR=1.62 [1.49-1.77]) increased the odds of receiving the diagnosis <18years. Multiple early factors contribute independently to a higher psychosis risk, suggesting cumulative effects leading to symptom onset. Routine assessments of the most influential risk factors could be incorporated into clinical practise. Being female increased the risk of diagnosis during childhood, suggesting sex differences in the developmental trajectories of the disorder.

Faktor-Faktor yang Berhubungan dengan Respiratory Distress pada Bayi Baru Lahir di Ruang Perinatologi RS X Jakarta

In newborns (BBL) respiratory disorders cause apnea, respiratory failure, to cardiac arrest and cause death. This study aims to determine the factors associated with respiratory distress in newborns in the perinatology ward of X Hospital from January 2018 to December 2020. The quantitative research method used an analytical survey approach (retrospective) and cross sectional design. The population is 795 BBL and the sample is 265 BBL using purposive sampling technique. The instrument used in the study was a medical record data collection form which contained data from the variables to be taken in this study.The bivariate analysis test used is the chi square test. The results of the study 56.6% of newborns experienced respiratory distress and came from a normal placental incidence of 94.7%; birth parity 1-3 times 95.1%; did not experience gestational diabetes 97.4% and women who were not pregnant 92.8%. The results of the bivariate test showed that there were no factors related to the occurrence of Respiratory Distress in newborns in the Perinatology room at X Hospital with a p-value&gt; 0.05.Conclusion: placental factors, parity, diseases experienced by the mother and gemelli are not related to the incidence of respiratory distress in newborns at X Hospital. It is expected that health workers will provide counseling about respiratory distress so that pregnant women understand more and can minimize the impact on the survival of the baby who was born.

Parental perspectives on a trial using waived informed consent at birth.

To determine parental perspectives in a trial with waived consent. Anonymous survey of birth parents with term infants who were randomized using a waiver of consent, administered after infant discharge. 121 (11%) survey responses were collected. Of the 121 responding parents 111 (92%) reported that this form of consent was acceptable and 116 (96%) reported feeling comfortable having another child participate in a similar study. 110 (91%) respondents reported that they both understood the information provided in the consent process and had enough time to consider participation. Four percent had a negative opinion on the study's effect on their child's health. Most responding parents reported both acceptability of this study design in the neonatal period and that the study had a positive effect on their child's health. Future work should investigate additional ways to involve parents and elicit feedback on varied methods of pediatric consent.

BMI Z-Score (SDS) versus Calculated Body Fat Percentage: Association with Cardiometabolic Risk Factors in Obese Children and Adolescents

Introduction: BMI or BMI-standardized deviation score (SDS) in children and adolescents is still the standard for weight classification. [BMJ. 2019;366:4293] developed a formula to calculate body fat percentage (%BF) based on age, sex, height, weight, and ethnicity. Using data from the German/Austrian APV registry, we investigated whether the calculated %BF is superior to BMI-SDS in predicting arterial hypertension, dyslipidaemia, and impaired glucose metabolism. Methods: 94,586 children and adolescents were included (12.5 years, 48.3% male). Parental birth country (BC) was used to depict ethnicity (15.8% migration background); 95.67% were assigned to the ethnicity “white.” %BF was calculated based on the Hudda formula. The relationship between BMI-SDS or %BF quartiles and outcome variables was investigated by logistic regression models, adjusted for age, sex, and migration background. Vuong test was applied to analyse predictive power. Results: 58.4% had arterial hypertension, 33.5% had dyslipidaemia, and 11.6% had impaired glucose metabolism. Boys were significantly more often affected, although girls had higher calculated %BF (each p < 0.05). After adjustment, both models revealed significant differences between the quartiles (all p < 0.001). The predictive power of BMI-SDS was superior to %BF for all three comorbidities (all p < 0.05). Discussion: The prediction of cardiometabolic comorbidities by calculated %BF was not superior to BMI-SDS. This formula developed in a British population may not be suitable for a central European population, which is applicable to this possibly less heterogeneous collective. Additional parameters, especially puberty status, should be taken into account. However, objective determinations such as bioimpedance analysis may possibly be superior to assess fat mass and cardiometabolic risk than calculated %BF.

Weaving webs of well-being: The ethics of navigating religious differences in Christian foster families with foster children of various backgrounds

This article analyzes ethical issues arising in transreligious foster care placements in relation to foster children’s needs regarding religious socialization and identification. Applying Urban Walker’s expressive-collaborative framework to 30 qualitative interviews with foster parents, foster children, parents, and professionals, we elaborate and apply a three-level reflection on Christian foster parents’ ethics of care in everyday practice of foster care. A first-level reflection demonstrates that integrating the foster child in the foster family often leads to predominant Christian socialization of foster children. A second-level reflection demonstrates asymmetry between foster parents and birth parents in the religious socialization of foster children, leading to confusion for the foster child and (potential) conflict with birth parents. Finally, a normative reflection leads us to conclude that foster children in transreligious placements need loose and hybrid moral frames in which they can alter, shift, and navigate their multiple identifications and partialities as part of their development.

The impact of maternal and paternal birth weights on infant birth weights: the Japan environment and children's study.

This study aimed to evaluate the association between parental and infant birth weights in Japan. In total, 37,504 pregnant Japanese women and their partners were included in this birth cohort study. A multinomial logistic regression model was used to evaluate the associations of parental birth weights with small-for-gestational-age (SGA) or large-for-gestational-age (LGA) infants. Associations between parental birth weight and low birth weight (LBW) infants or macrosomia were also examined, and linear associations between parental birth weight and SGA or LGA were found. The adjusted odds ratios (aORs) for SGA infants per 500 g decrease in maternal and paternal birth weights were 1.50 (95% confidence interval [CI],1.43-1.58) and 1.31 (95% CI, 1.25-1.38), respectively. The aORs for LGA infants per 500 g increase in maternal and paternal birth weights were 1.53 (95% CI, 1.47-1.60) and 1.41 (95% CI, 1.35-1.47), respectively. The association between parental birth weight and LBW infants or macrosomia was also linear. The aORs for LBW infants per 500 g decrease in maternal and paternal birth weights were 1.47 (95% CI, 1.40-1.55) and 1.25 (95% CI, 1.19-1.31), respectively. The aORs for macrosomia per 500 g increase in maternal and paternal birth weights were 1.59 (95% CI, 1.41-1.79) and 1.40 (95% CI, 1.23-1.60), respectively. Parental birth weight was found to be associated with infant birth weight even after adjusting for various parental factors. Furthermore, maternal birth weight was more strongly associated with infant birth weight than with paternal birth weight.