Children Of White Mothers Research Articles

Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies

Racism is a social determinant of health inequities. In Brazil, racial injustices lead to poor outcomes in maternal and child health for Black and Indigenous populations, including greater risks of pregnancy-related complications; decreased access to antenatal, delivery, and postnatal care; and higher childhood mortality rates. In this study, we aimed to estimate inequalities in childhood mortality rates by maternal race and skin colour in a cohort of more than 19 million newborns in Brazil. We did a nationwide population-based, retrospective cohort study using linked data on all births and deaths in Brazil between Jan 1, 2012, and Dec 31, 2018. The data consisted of livebirths followed up to age 5 years, death, or Dec 31, 2018. Data for livebirths were extracted from the National Information System for livebirths, SINASC, and for deaths from the Mortality Information System, SIM. The final sample consisted of complete data for all cases regarding maternal race and skin colour, and no inconsistencies were present between date of birth and death after linkage. We fitted Cox proportional hazard regression models to calculate the crude and adjusted hazard ratios (HRs) and 95% CIs for the association between maternal race and skin colour and all-cause and cause-specific younger than age 5 mortality rates, by age subgroups. We calculated the trend of HRs (and 95% CI) by time of observation (calendar year) to indicate trends in inequalities. From the 20 526 714 livebirths registered in SINASC between Jan 1, 2012, and Dec 31, 2018, 238 436 were linked to death records identified from SIM. After linkage, 1 010 871 records were excluded due to missing data on maternal race or skin colour or inconsistent date of death. 19 515 843 livebirths were classified by mother's race, of which 224 213 died. Compared with children of White mothers, mortality risk for children younger than age 5 years was higher among children of Indigenous (HR 1·98 [95% CI 1·92-2·06]), Black (HR 1·39 [1·36-1·41]), and Brown or Mixed race (HR 1·19 [1·18-1·20]) mothers. The highest hazard ratios were observed during the post-neonatal period (Indigenous, HR 2·78 [95% CI 2·64-2·95], Black, HR 1·54 [1·48-1·59]), and Brown or Mixed race, HR 1·25 [1·23-1·27]) and between the ages of 1 year and 4 years (Indigenous, HR 3·82 [95% CI 3·52-4·15]), Black, HR 1·51 [1·42-1·60], and Brown or Mixed race, HR 1·30 [1·26-1·35]). Children of Indigenous (HR 16·39 [95% CI 12·88-20·85]), Black (HR 2·34 [1·78-3·06]), and Brown or Mixed race mothers (HR 2·05 [1·71-2·45]) had a higher risk of death from malnutrition than did children of White mothers. Similar patterns were observed for death from diarrhoea (Indigenous, HR 14·28 [95% CI 12·25-16·65]; Black, HR 1·72 [1·44-2·05]; and Brown or Mixed race mothers, HR 1·78 [1·61-1·98]) and influenza and pneumonia (Indigenous, HR 6·49 [95% CI 5·78-7·27]; Black, HR 1·78 [1·62-1·96]; and Brown or Mixed race mothers, HR 1·60 [1·51-1·69]). Substantial ethnoracial inequalities were observed in child mortality in Brazil, especially among the Indigenous and Black populations. These findings demonstrate the importance of regular racial inequality assessments and monitoring. We suggest implementing policies to promote ethnoracial equity to reduce the impact of racism on child health. MCTI/CNPq/MS/SCTIE/Decit/Bill & Melinda Gates Foundation's Grandes Desafios Brasil, Desenvolvimento Saudável para Todas as Crianças, and Wellcome Trust core support grant awarded to CIDACS-Center for Data and Knowledge Integration for Health.

Associations between breastfeeding duration and overweight/obese among children aged 5-10: a focus on racial/ethnic disparities in California.

Research on the association between breastfeeding and childhood obesity and research on racial/ethnic differences in breastfeeding both show inconsistencies. The current study examines: 1) whether immigrant Hispanic women have higher rates of breastfeeding compared to non-Hispanic (three separate groups: African-American, Asian/Pacific Islander, and White) and U.S.-born Hispanic women; 2) whether children who were breastfed are less likely to be overweight/obese compared to children who were not breastfed; and 3) whether associations between breastfeeding and weight status vary by race/ethnicity/nativity. The study builds on prior literature using representative data from the Geographic Research On Wellbeing study (GROW, 2012–2013) and focusing on ages 5–10 years, an age group that has not been well studied (N = 2675 mother/child dyads). Logistic regression was used to investigate the odds of child obesity (≥95th%) and child overweight (≥85th%) in a series of models: unadjusted (each variable individually), demographic (child's sex, child's age, mother's age, mother's race/ethnicity, and mother's marital status), socioeconomic status (mother's education and family income), and full model (mother's BMI); with breastfeeding included in all models. Interactions between race/ethnicity and breastfeeding duration were also examined. African-American (9.54%) and white (32.8%) women had the lowest and highest rates of ever breastfeeding, respectively. White women breastfed the longest (M = 10.52 months, SE = 0.028) and U.S.-born Hispanic women breastfed the shortest (M = 7.05 months, SE = 0.41), on average. Children of African-American and U.S.-born Hispanic mothers had higher odds of being overweight/obese (74–75%) compared with children of white mothers. No associations were found between breastfeeding duration and child's weight status in adjusted models, nor was there a significant interaction between mother's race/ethnicity and breastfeeding duration on child's weight status; however, mother's own weight status was a significant driver of child's weight status and explained the racial/ethnic disparities. These results provide evidence in favor of there being no association between breastfeeding and childhood obesity.

P2-319 Cord blood vitamin D levels are associated with early life atopic dermatitis

IntroductionVitamin D deficiency (25-hydroxyvitamin D [25(OH)D]<50 nmol/l) is epidemic in many regions. Recent evidence indicates a possible association between low vitamin D levels and early life allergic disease.MethodsWe examined the...

Television Viewing by Young Hispanic Children

To determine if hours of daily television viewed by varying age groups of young children with Hispanic mothers differs by maternal language preference and to compare these differences with young children with white mothers. Cross-sectional analysis of data collected in 2000 from the National Survey of Early Childhood Health. Nationally representative sample. One thousand three hundred forty-seven mothers of children aged 4 to 35 months. Subgroups of self-reported maternal race/ethnicity (white or Hispanic) and within Hispanic race/ethnicity, stratification by maternal language preference (English or Spanish). Hours of daily television the child viewed. Bivariate analyses showed that children of English- vs Spanish-speaking Hispanic mothers watched more television daily (1.88 vs 1.31 hours, P < .01). Multivariable regression analyses stratified by age revealed differences by age group. Among 4- to 11-month-old infants, those of English- and Spanish-speaking Hispanic mothers watched similar amounts. However, among children aged 12 to 23 and 24 to 35 months, those of English-speaking Hispanic mothers watched more television than children of Spanish-speaking Hispanic mothers (incidence rate ratio [IRR], 1.61; 95% confidence interval [CI], 1.17-2.22; IRR, 1.66; 95% CI, 1.10-2.51, respectively). Compared with children of white mothers, children of both Hispanic subgroups watched similar amounts among the 4- to 11-month-old group. However, among 12- to 23-month-old children, those of English-speaking Hispanic mothers watched more compared with children of white mothers (IRR, 1.57; 95% CI, 1.18-2.11). Among 24- to 35-month-old children, those of English-speaking Hispanic mothers watched similar amounts compared with children of white mothers, but children of Spanish-speaking Hispanic mothers watched less (IRR, 0.69; 95% CI, 0.50-0.95). Television-viewing amounts among young children with Hispanic mothers vary by child age and maternal language preference, supporting the need to explore sociocultural factors that influence viewing in Hispanic children.