Mothers Of Low Socioeconomic Status Research Articles

The stratified effect of extreme temperatures on birth weight: the role of energy prices

This paper fills a notable gap in the existing literature on birth outcomes and extreme temperatures by examining the causal moderating effect of energy prices on the impact of extreme temperatures during pregnancy on birth weight. It uses a sharp increase in energy prices that occurred in Spain in March 2021 as an identification strategy and incorporates a new weather dataset that increases the number of monitors from which temperature information is derived in previous research by more than sixfold. The results show that the negative effects of extreme temperatures on birth weight are amplified at higher energy prices, especially for mothers of lower socioeconomic status. By focusing on how energy prices moderate the impact of extreme temperatures on birth outcomes, opportunities arise for policy interventions aimed at reducing health inequalities at birth. Moreover, given the critical role that events in utero play in individuals’ later development, such policies have the potential not only to reduce health inequalities at birth, but also to address broader inequalities in long-term outcomes.

Strength Amidst Struggles: A Descriptive Qualitative Study of Maternal Experiences of Low Socioeconomic Status Mothers in the Third Month Postpartum.

To explore the experiences, expectations and needs of mothers from low socioeconomic status at 3 months postpartum. Descriptive qualitative. Mothers aged 21 years old and above, from low socioeconomic status (monthly household income is less than Singapore Dollar [SGD] $4300), and irrespective of their parity were invited to participate in one-to-one in-depth interviews at 3 months postpartum from September 2022 to June 2023. A semistructured guide was used in the interviews, which were conducted until data saturation. A trained researcher conducted the interviews that were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained and voluntary participation was reinforced. Twenty mothers participated in this study and four themes were identified: (1) difficult trade-offs; (2) help-seeking behaviours and (3) 'But if?' Concerns about Emergencies. This study explored the difficult circumstances that mothers from low socioeconomic status face in their third month postpartum, and how wider societal inequalities exacerbated these circumstances. Current policies and practices need to be relooked, reframed, and reformed to address the unique needs of this community. Nurses should keep mothers' struggles in balancing employment and childcare in consideration and explore other ways of supporting the low socioeconomic status mothers such as online modes in providing patient education and peer support. Mothers from low socioeconomic status are less likely to seek formal help from healthcare professionals, external organizations and the government. These mothers need flexible, affordable and accessible childcare options to return to work. More targeted family-oriented policies that create empowering and understanding workplaces in Singapore could help ease the stress on mothers returning to employment postpartum. Online peer support groups consisting of mothers of similar socioeconomic backgrounds could help engage and retain this hard-to-reach yet vulnerable population. COREQ checklist. No patient or public contribution.

Cradling disparities: A descriptive qualitative study of maternal experiences of mothers from low-socioeconomic status in the first month postpartum.

To explore the experiences, expectations and needs of mothers from low-socioeconomic status at 1 month postpartum. Descriptive qualitative. Mothers from low-socioeconomic status and irrespective of their parity were invited to participate in one-to-one interviews at 1 month postpartum. Semi-structured interviews were conducted until data saturation. Interviews were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained. Twenty mothers participated and six themes were identified: (1) No choice but to find meaning; (2) Father as a major pillar of support; (3) 'Kampung' Spirit; (4) Trials and Tribulations of Transition to Motherhood; (5) Shame, guilt and internalized stigma and (6) Reclaiming the power. This study reflected the unique struggles of mothers from low-socioeconomic status with pregnancy, childbirth and early postpartum and the wider health inequities within Singapore's maternal health system. To provide much-needed support and improved care, the stakeholders within government, healthcare providers and social organizations should consider the niche needs of this community. Nurses need to reflect on their own biases and ensure consistent care delivery regardless of socioeconomic status. When delivering patient education, patient-centred and sincere advice rooted in personal experience can help to establish rapport. This study is the first to explore the experiences of mothers from low-socioeconomic status in the Singapore context. Low-socioeconomic status mothers experienced less autonomy over their health, the care they received and their childcare options. As mothers adjusted to their new roles, they struggled to cope. However, as they were wary of the stigma surrounding poverty and their guilt of not being a 'good mother', they preferred to seek informal support from their family, friends and self-help through learning from social media, as compared to formal, external help. COREQ checklist. No patient or public contribution.

Diet quality and nutritional status of HIV-exposed children aged between 6 and 18 months in the Greater Accra Region of Ghana

IntroductionHIV-exposed children, even when uninfected, have a greater risk of malnutrition than unexposed counterparts. WHO guidelines recommend children aged 6–23 months be fed a variety of foods to meet nutrient requirements. This study aimed to determine infant and young child feeding (IYCF) practices among HIV-exposed children under 2 years old enrolled in a dietary intervention and to explore correlates of the IYCF indicators and associations between IYCF and nutritional status.MethodologySix hundred and eighty mother–child pairs were recruited from 19 health facilities from the Greater Accra Region. The sociodemographic data, anthropometry, hemoglobin, and dietary intake were recorded.ResultsNinety-five percent of HIV-positive mothers breastfed their babies, and 53% initiated breastfeeding in a timely manner. Around one in five mothers (21%) introduced liquids other than breastmilk to their children within the first 2 days of birth, and only around one in four children (26%) aged 12–23 months had received breast milk on the day before assessment. Ninety-three percent of babies between 6 and 8 months had been introduced to solid, semi-solid, or soft foods. Eighteen percent of children reached the threshold for Minimum Dietary Diversity (MDD) by eating from over five of eight food groups. Fifty-four percent received Minimum Meal Frequency (MMF), eating between 2 and 4 meals in a day. Eleven percent received the Minimum Acceptable Diet (MAD). Thirty-two percent were anemic. Underweight and stunting were 12 and 11%, respectively. Children of mothers aged 31–40 years were more likely to meet the MDD and MAD [OR = 2.8, 95%CI (1.185, 6.519), p < 0.05 and OR = 2.8, 95%CI (1.256, 6.279), p < 0.05] compared to children of mothers aged 30 years or less or aged above 40 years. Children from households earning more than GHS 500 were more likely to meet MMF than those from households earning less. No associations were found between IYCF and nutritional status.ConclusionFindings highlight the need for nutrition programs to educate HIV-exposed children’s caregivers on optimal feeding practices. The importance of continued breastfeeding and dietary diversity needs to be highlighted. Affordable, iron-rich foods should be promoted. Special attention should be paid to younger, less educated, and lower socioeconomic status mothers.

Prenatal Cannabis Use and Offspring Autism-Related Behaviors: Examining Maternal Stress as a Moderator in a Black American Cohort

Prenatal cannabis use and maternal stress have been proposed as risk factors for autism spectrum disorder (ASD). Black mothers and mothers of lower socioeconomic status (SES) may be especially likely to experience high levels of stress. This study examined the impact of prenatal cannabis use and maternal stress (i.e., prenatal distress, racial discrimination, and lower SES) on child ASD-related behaviors in a sample of 172 Black mother-child pairs. We found that prenatal stress was significantly associated with ASD-related behaviors. Prenatal cannabis use did not predict ASD-related behaviors and did not interact with maternal stress to predict ASD-related behaviors. These findings replicate previous work on prenatal stress-ASD associations and add to the limited literature on prenatal cannabis-ASD associations in Black samples.

Disability Is Not a Burden: The Relationship between Early Childhood Disability and Maternal Health Depends on Family Socioeconomic Status.

Narratives rooted in ableism portray disabled children as burdens on their families. Prior research highlights health disparities between mothers of disabled children and mothers of nondisabled children, but little is known about how socio-structural contexts shape these inequities. Using longitudinal data from the Future of Families and Child Wellbeing Study (n = 2,338), this study assesses whether the relationship between early childhood disability and maternal health varies by household socioeconomic status (SES). Findings reveal that, on average, mothers of children disabled by age five report worse health than mothers of nondisabled children; however, this pattern is only evident among lower SES mothers and disappears for higher SES mothers. Contextualizing the findings within the systemic ableism literature highlights how-instead of portraying disabled children as burdens on their families-scholars and policymakers should focus on how ableism and poverty burden disabled people and their families in ways that pattern health risks.

The Work of Breastfeeding Among Women of Low Socioeconomic Status: A Qualitative Metasynthesis

A theory-generating qualitative metasynthesis was used to explore the questions: (a) How do mothers of low socioeconomic status in the United States express their attitudes and beliefs on breastfeeding? (b) How do mothers of low socioeconomic status in the United States describe the types of support received related to breastfeeding? Databases were searched from January 2000 to June 2022. Eleven qualitative studies were evaluated, and six themes were identified. A model was developed illustrating how the themes impact a mother’s decision to breastfeed. Positive factors included shared narratives, knowledge of breastfeeding physiology, and social network. However, more negative influences were heard such as opinions passed on from family and friends, lack of teaching and anticipatory guidance, limited support and follow up, and the perception of conflicting messages from health care professionals. This model identifies constructs that can be used as starting points for interventions, policy development and/or health promotion education.

Gauging the correlation between anthropometric measurements to birth weight in subjects of urban lower socioeconomic status in Mumbai

Background: Birth weight is largely influenced by the mother's parity, gender of the baby, conceptus number, and maternal environment. The heavier weight is seen for male babies at full-term compared to females, in singleton compared to twins, and in later-born compared to the first baby. Low-weight babies are seen in mothers of lower socioeconomic status. In urban lower socioeconomic group females, the closest correlation is seen with neonatal calf circumference. Aim: The present study was conducted to perceive the anthropometric parameters that have the best correlation with the birth weight in the urban lower socioeconomic population of Mumbai. Methods: From the post-natal ward of Sir JJ group of hospital and Cama hospital, 200 newborns who were normal-delivered, newborns, singletons, born to females with no history of infections like tuberculosis, hypertension, and diabetes mellitus were assessed. In 200 included subjects, anthropometric parameters and birth weight were assessed. Results: Good correlation was seen in both females and males between birth weight and calf circumference, thigh circumference, mid-arm circumference, and abdominal circumference. However, poor correlation in females and good correlation in males was seen in chest circumference, head circumference, and crown to heel length.

Socio-demographic determinants of undernutrition of preschool children attending anganwadis in rural ICDS block, North Kerala

Child growth and health is recognized as an important public health indicator for monitoring nutritional status and health in a population.1. To study the socio demographic profile of the preschool children (3-6years) attending anganwadis in Kunnamangalam. 2. To study the association between socioeconomic status and undernutrition.A cross sectional study was done among 30 anganwadis from June 2014 to June 2015 by cluster sampling method. Data regarding socio demographic factors, prevalence of undernutrition were collected by using a pre tested semi structured questionnaire. Socio economic status of the study population was classified according to Modified Kuppu Swamy’s Scale. Education, Occupation and total monthly family income of the highest earning member was used for the stratification into various classes. Data analysed using SPSS version 16 software.Out of 300 children, 204 (68%) belonged to Upper lower strata, 74 (24.7%) were lower middle, 19 (6.3%) were upper middle and 3(1%) belonged to upper class. Prevalence of underweight children was significantly higher in children among those belonging to lower socioeconomic status.The study suggests to focus on preschool children for growth monitoring especially in low socioeconomic families, approaching them through the help of anganwadis, and educating mothers of low socioeconomic status on health on promoting program for underfives.

Vulvo-vaginal myiasis among rural women in West Bengal, India

Myiasis, the infestation of living or dead tissue of vertebrates by larvae (maggots) of dipterous flies, is well-known in the medical field. Different parts of the human body, such as skin, oral, nasal, urogenital are affected and named accordingly. The present study was a clinic-entomological study where the women having vulvo-vaginal myiasis were included. Maggots were collected, cultured, and adult flies were identified. A total of 34 cases of vulvo-vaginal myiasis were treated. The larvae of 29 cases were cultured into adults. Most of the women are rural (94%), illiterate and from a low socioeconomic society. The authors specified the infested sites of vulva and vagina such as vaginal, labia, clitoris, episiotomy wound, vulval growth, and prolapsed uterus. The episiotomy wound (32%) is the most common infestation site, followed by the vagina (26%). Chrysomya bezziana (76%) and Chrysomya megacephala (24%) are the identified flies. Illiterate, rural puerperal mothers of low socioeconomic status without proper health education and basic hygiene knowledge are vulnerable to myiasis.

Stakeholders' Views on Mobile Applications to Deliver Infant and Toddler Feeding Education to Latina Mothers of Low Socioeconomic Status.

Infant- and toddler-feeding (ITF) practices are critical to long-term health and chronic disease prevention. Using mobile applications (apps) to promote desirable ITF practices shows promise for overcoming challenges of in-person education. However, the viability of ITF apps for Latina mothers of low-socioeconomic status (SES) remains unclear. The objective of this study was to characterize stakeholders’ views on Latina mothers’ capability, motivation, and barriers to using ITF apps. New York City-based health professionals who frequently engage with Latina mothers of low SES completed in-depth interviews. Directed content analysis was used to identify themes through theoretical and inductive codes. Participants included dietitians, nutrition educators, and physicians (n = 17). The following themes were identified: (1) Most Latina mothers of low-SES are tech-savvy (i.e., high capability and experience using smartphones and apps); (2) Apps are an appealing way to deliver ITF education; (3) There are challenges to using apps that must be carefully considered for ITF education development. Overall, ITF apps are a viable option as skills and use appear high among Latina mothers. Key considerations for app development include targeted app promotion; detailed instructions for obtaining and using app; more visuals, less text for low literacy and multiple dialects; making key features available offline.

Better late than never? Maternal biopsychosocial predictors of late follow-up from new Jersey's early hearing detection and intervention program

ObjectivesEarly hearing detection and intervention programs are designed to mitigate consequences of hearing loss in infants. Most research examining compliance with program protocols has examined factors related to being lost to follow-up. Another group that warrants study are babies who return for follow-up outside the timelines recommended by public health organizations. This research seeks to identify maternal factors that are associated with late follow-up at the point of diagnosis of hearing loss. Study designThe sampling frame for this study included all babies born in New Jersey in a two-year period. Our final sample consisted of 716 babies who needed diagnostic evaluations and completed them. Five hundred twenty-six babies completed their exams on-time while 190 completed them late. Logistic regression was completed to identify maternal factors related to late follow-up, and additional statistics were utilized to understand characteristics of babies who were late. ResultsIn the final modeling, maternal education (OR = 0.52), WIC participation (OR = 2.11), and health insurance status (OR = 2.04) were significantly predictive of being late (X2 (6) = 77.71; p < 0.01). Mothers for whom postpartum depression (OR = 1.89) was a concern were more also likely to have babies who were late. Needing to repeat a diagnostic audiologic exam was most predictive of lateness (OR = 5.32). Over one-third of babies who had confirmed hearing loss completed their testing late. ConclusionsLate completion of diagnostic hearing tests may contribute to delays in children hitting developmental milestones in a timely manner. Low socioeconomic status mothers and those with postpartum depression may have difficulty following up with recommended hearing tests. Limitations include data quality issues inherent in using administrative data.

Outcomes of Equity-Oriented, Web-Based Parenting Information in Mothers of Low Socioeconomic Status Compared to Other Mothers: Participatory Mixed Methods Study.

BackgroundTypically, web-based consumer health information is considered more beneficial for people with high levels of education and income. No evidence shows that equity-oriented information offers equal benefits to all. This is important for parents of low socioeconomic status (SES; low levels of education and income and usually a low level of literacy).ObjectiveThis study is based on a conceptual framework of information outcomes. In light of this, it aims to compare the perception of the outcomes of web-based parenting information in low-SES mothers with that of other mothers and explore the perspective of low-SES mothers on contextual factors and information needs and behavior associated with these outcomes.MethodsA participatory mixed methods research was conducted in partnership with academic researchers and Naître et grandir (N&G) editors. N&G is a magazine, website, and newsletter that offers trustworthy parenting information on child development, education, health, and well-being in a format that is easy to read, listen, or watch. Quantitative component (QUAN) included a 3-year longitudinal observational web survey; participants were mothers of 0- to 8-year-old children. For each N&G newsletter, the participants’ perception regarding the outcomes of specific N&G webpages was gathered using a content-validated Information Assessment Method (IAM) questionnaire. Differences between participants of low SES versus others were estimated. Qualitative component (QUAL) was interpretive; participants were low-SES mothers. The thematic analysis of interview transcripts identified participants’ characteristics and different sources of information depending on information needs. Findings from the two components were integrated (QUAN+QUAL integration) through the conceptual framework and assimilated into the description of an ideal-typical mother of low SES (Kate). A narrative describes Kate’s perception of the outcomes of web-based parenting information and her perspective on contextual factors, information needs, and behavior associated with these outcomes.ResultsQUAN—a total of 1889 participants completed 2447 IAM responses (50 from mothers of low SES and 2397 from other mothers). N&G information was more likely to help low-SES participants to better understand something, decrease worries, and increase self-confidence in decision making. QUAL—the 40 participants (21 N&G users and 19 nonusers) used 4 information sources in an iterative manner: websites, forums, relatives, and professionals. The integration of QUAN and QUAL findings provides a short narrative, Kate, which summarizes the main findings.ConclusionsThis is the first study comparing perceptions of information outcomes in low-SES mothers with those of other mothers. Findings suggest that equity-oriented, web-based parenting information can offer equal benefits to all, including low-SES mothers. The short narrative, Kate, can be quickly read by decision policy makers, for example, web editors, and might encourage them to reach the underserved and provide and assess trustworthy web-based consumer health information in a format that is easy to read, listen, or watch.

The Decomposition of Socioeconomic Factors in Inequality in Preterm Birth; the Results of a Cohort Study Based on the Concentration Index Approach

Background: Preterm labor is a crucial factor in neonatal morbidity and mortality. The present study aims to investigate the effects of Socioeconomic Status (SES) on preterm birth and to decompose the main inequalities affecting preterm birth. Materials and Methods: In a cohort study in 2017, 458 pregnant women in Ilam, Iran, were followed from the 20th gestational week up to the labor. All participants were followed up according to the Prenatal Care Schedule approved by the Ministry of Health of the Islamic Republic of Iran from the beginning to the end of the study. The results of participants' laboratory tests were collected based on the records from their pregnancy documents. A code was inserted in the prenatal care booklet of each participant for exchanging information between the researcher and participants. The Concentration Index (CI) was used to determine inequality. The Inequality Index was decomposed to find out the main sources of inequality in preterm infants. Distributive Analysis Stata Package was used for estimating CI. Results: Of the total of 458 participants, 12% had preterm labor. The number of male newborns was 219 (47.8%). Also, the prevalence of preterm labor was more in mothers aged 20 to 31 years (p < 0.001), housewives (p=0.037), and women with lower socioeconomic status (p < 0.001). The socioeconomic contributors to inequality were the mother’s age (p=0.008), father’s age (p=0.005), father’s education (p=0.003), and father's job (p < 0.001). The main factors of inequality were mother’s age (8%), father’s age (3%), father’s education (5%), and father's job (25%). Conclusion: Overall, 12% of our study population had preterm labor. Preterm birth was significantly more observed among mothers of lower socioeconomic status. Some SES, including the mother's age, father’s age, father’s education, and father’s job, were important factors in preterm inequality among Iranian mothers.

Lead in Drinking Water and Birth Outcomes: A Tale of Two Water Treatment Plants

The recent drinking water crisis in Newark, New Jersey's largest city, has renewed concerns about the lead-in-water crisis becoming a persistent and widespread problem owing to the nation's aging infrastructure. We exploit a unique natural experiment in Newark, which exogenously exposed some women in the city to higher levels of lead in tap water but not others, to identify a causal effect of prenatal lead exposure on fetal health. Using birth data that contain information on mothers' exact residential addresses, we find robust and consistent evidence that prenatal exposure to lead significantly raises the probability of low birth weight or preterm births by approximately 1.4 to 1.9 percentage points (14-22 percent), and the adverse effects are largely concentrated among mothers of lower socioeconomic status. Our findings have important policy implications in light of the long-term impact of compromised health at birth and the substantial number of lead water pipes that remain in use as part of our aging infrastructure. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Assessing the Impacts of Pediatric Primary Care Parenting Interventions on EI Referrals Through Linkage With a Public Health Database

We sought to determine whether pediatric primary care interventions targeting positive parenting among low socioeconomic status mothers resulted in reduced referrals to the New York City Early Intervention Program (NYC-EIP). Participants in Building Blocks (BB) and the Video Interaction Project (VIP) were linked with the NYC-EIP administrative dataset to determine referrals. In all, 139 of 422 study participants (31.4%) meeting inclusion criteria were referred to the NYC-EIP. Although referrals did not differ overall by group (VIP 29.8%; BB 33.8%; control 35.3%), differences were found for mothers with education/literacy of seventh grade or higher (interaction p = .02). In that subgroup, VIP was associated with reduced referrals by age 3 years (22.4%; adjusted odds ratio 0.53; 95% confidence interval [0.29, 0.97]), compared with BB (35.0%) and controls (34.3%), with survival analysis showing reduced cumulative risk ( p = .04). We conclude that VIP resulted in reduced referrals for early intervention evaluation among children of mothers with seventh-grade education or higher.

An Insight Into the Involvement of Mothers of Low Socioeconomic Status in Scottish Primary School Health Education Activities

School-based health activities that involve parents are more likely to be effective for child health and well-being than activities without a parent component. However, such school-based interventions tend to recruit the most motivated parents, and limited evidence exists surrounding the involvement of hard-to-reach parents with low socioeconomic status (SES). Mothers remain responsible for the majority of family care; therefore, this study investigated mothers with low SES to establish the reasons and barriers to their involvement in school-based health activities and to propose strategies to increase their involvement in those activities. Interviews were conducted with mothers with low SES, who were typically not involved in school-based health activities (n = 16). An inductive-deductive approach to hierarchical analysis revealed that there are several barriers resulting in mothers being less involved, particularly due to issues surrounding the schools' Parent Councils and the exclusivity of school-based events. Efforts made by the school to promote health activities and involve parents in such activities were revealed, alongside recommendations to improve on these practices. The findings offer multiple ways in which future school-based health interventions can recruit and involve mothers with low SES.

Stress and Food Preferences: A Lab Experiment with Low-Ses Mothers

We investigate whether short-term everyday stressors leads to unhealthier dietary choices among low socioeconomic status mothers. We propose a novel stress protocol that aims to mimic everyday stressors experienced by this population, involving time and financial pressure. We evaluate the impact of stress on immediate and planned food choices, comparing a group exposed to our stress protocol relative to a control group. Immediate consumption is measured with in-laboratory consumption of low calorie and high calorie snacks; planned consumption is measured with an incentivized food shopping task. The stressfulness of the stress protocol is evaluated using subjective assessments, as well as physiological measurements (heart rate and salivary cortisol levels). We find no evidence of an effect of stress on the nutritional content of immediate or planned food consumption, thus no support for the hypothesis that everyday stressors are a likely explanation for unhealthy food choices.

The effect of marital and migrant status on the psychological distress of low socioeconomic mothers and their children in Israel

Children who live in conditions of poverty are at high risk for developmental and emotional difficulties. This study compared the psychological distress of migrant workers in Israel and their children with the psychological distress of low socioeconomic Israeli mothers and their children. We hypothesized that migrant working mothers and their children would show higher levels of distress than Israeli mothers and their children, and that single mothers and their children would show higher levels of distress than married mothers and their children. Three hundred and twenty-three mothers aged 25–59 and their children aged 6–12 participated in the study. One hundred and sixty-seven mothers were migrant workers, mostly from the Philippines, and 156 were Israeli working mothers of low socioeconomic status. One hundred and fifty-seven of the mothers were married and 143 were single. The mothers completed a measure of psychological distress and measures of their children's behavioral problems, psychological functioning, and satisfaction with life. The children completed measures of negative life events, subjective competence and psychological functioning. Overall, hypotheses were confirmed for children but not mothers, although migrant mothers reported higher levels of depressive symptoms than Israeli mothers. Levels of psychological distress were similar in single versus married mothers. In contrast, children whose mothers were migrant workers or single working mothers were at significantly higher psychological risk than children of Israeli mothers or married mothers respectively. This study contributes to an understanding of problem domains that should be addressed in welfare, and points to the need for psychological interventions for migrant and single-mother families that foster positive mother-child communication and interaction.

The Mexican Drug War and Early-Life Health: The Impact of Violent Crime on Birth Outcomes.

This study examines the relationship between exposure to violent crime in utero and birth weight using longitudinal data from a household survey conducted in Mexico. Controlling for selective migration and fertility, the results suggest that early gestational exposure to the recent escalation of the Mexican Drug War is associated with a substantial decrease in birth weight. This association is especially pronounced among children born to mothers of low socioeconomic status and among children born to mothers who score poorly on a mental health index.