Maternal Education Level Research Articles

Abstract P074: Pregnancy and neonatal outcomes among early-onset colorectal cancer survivors: a nationwide case-control study

Abstract Purpose: Early-onset colorectal cancer (CRC diagnosed before age 50) has risen worldwide, with an increasing number of survivors of reproductive age. We aimed to investigate the risk of adverse pregnancy and neonatal outcomes among early-onset CRC survivors. Methods: We conducted a nationwide case-control study of 207 births in women with early-onset CRC and 1019 births in women without CRC from the general Swedish population (1992-2019), matched on age, calendar year of birth, parity, and county of residence. To control for genetic susceptibility and shared childhood exposures, we additionally identified 146 births in female siblings of the CRC survivors. Early-onset CRC cases were identified through the Swedish Cancer Register (1969-2019), and siblings were identified through the Swedish Multi-generation Register. Maternal characteristics and neonatal outcomes were retrieved from the Swedish Medical Birth Register and National Patient Register. Using conditional logistic regression, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: Compared to women without prior CRC, early-onset CRC survivors who gave birth had increased risk of pre-eclampsia (aOR 2.52, 95% CI 1.25 to 5.08), induced labor (aOR 1.64, 95% CI 1.09 to 2.46) and emergency Cesarean section (aOR 1.79, 95% CI 1.17 to 2.75), after adjustment for maternal education level, country of birth, body mass index and smoking in early pregnancy, and comorbidities. Sibling analyses showed similar trends, especially for higher risk of induced labor (aOR 2.58, 95% CI 1.03 to 6.49). Maternal history of early-onset CRC was also associated with offspring preterm birth (aOR 2.31, 95% CI 1.34 to 3.99) and low birth weight (aOR 2.95, 95% CI 1.40 to 6.21), and risks were particularly pronounced for medically indicated preterm birth (aOR 4.48, 95% CI 2.05 to 9.79). No significant associations were found for small for gestational age birth, low Apgar score, and congenital malformations. Conclusion: In this population-based study, history of early-onset CRC was associated with increased risk of adverse pregnancy outcomes, including pre-eclampsia, induction of labor, and emergency Cesarean section. Offspring to mothers with early-onset CRC also had increased risk of medically indicated preterm birth and neonatal low birth weight. Citation Format: Yin Cao, Stephanie Zhao, Tomas S. Bexelius, Jonas Söderling, Mengyao Shi, Bjorn Roelstraete, Barbara B. Warner, Olof Stephansson, Jonas F. Ludvigsson. Pregnancy and neonatal outcomes among early-onset colorectal cancer survivors: a nationwide case-control study. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P074.

Congenital syphilis: associated factors in a follow-up outpatient clinic.

This study aimed to describe the characteristics of mothers and children assisted in a follow-up clinic for congenital syphilis and identify the factors associated with the confirmation of the diagnosis. This is a prospective study conducted from 2016 to 2019 in Montes Claros, Northern Minas Gerais, Brazil. Specific forms addressing maternal sociodemographic, behavioral, and lifestyle habit characteristics, as well as characteristics related to access to healthcare, were used. Hierarchical Poisson regression analysis was performed to define the factors associated with diagnostic confirmation, including the calculation of the prevalence ratios (PR) and respective 95% confidence intervals (95%CI). A total of 200 binomials (mother-child) who attended at least one appointment as part of the follow-up after discharge from the maternity hospital were eligible for the study. Themothers were mostly young (79.0%), with a low educational level (43.0%), and black (89.5%). Nearly half of the mothers reported not having a steady sexual partner (42.5%). About a quarter attended less than six prenatal appointments (27.5%). Nearly half did not treat the disease adequately during pregnancy (24.5%). The diagnosis of congenital syphilis was confirmed for 116 children. The following factors were associated with the diagnostic confirmation after multiple analyses: low maternal educational level (PR 1.30; 95%CI 1.05-1.60), maternal risky sexual behavior (PR 1.34; 95%CI 1.07-1.66), inadequate treatment of the mother (PR 3.16; 95%CI 2.42-4.47), and lack of treatment of the partner (PR 1.44; 95%CI 1,18-1.81). Syphilis remains a major challenge. The results highlight the social inequities associated with congenital syphilis and the lack of proper management of pregnant women and their partners.

Knowledge and practices on childhood anaemia, thalassaemia and iron deficiency among mothers of children aged between 6 and 59 months in a suburban area of Sri Lanka

BackgroundChildhood anaemia is one of the most common public health problems worldwide. Here, we aim to describe the knowledge and practices on childhood anaemia, thalassaemia and iron deficiency among mothers of children aged between 6 and 59 months in a suburban district of Sri Lanka.MethodsWe performed a cross-sectional survey in the Gampaha District of Sri Lanka from December 2020 to February 2021. One well-baby clinic each from four Medical Officer of Health areas in the district was selected using stratified random sampling. Mothers of all children aged between 6 and 59 months attending well-baby clinics were recruited until the sample size was achieved. Data were collected using a self-administered questionnaire and analysed using logistic regression.ResultsA total of 392 mothers were recruited; 53% of their children were males. Only 33% of mothers had an accurate understanding of anaemia, while 71% and 28%, respectively, could name at least one symptom and two causes of anaemia; 12% could not name a single food rich in iron. Only 13% of mothers knew that thalassaemia is a cause of anaemia, and 14% had been screened for thalassaemia. Logistic regression analysis that examined for factors associated with higher knowledge of anaemia revealed that an accurate understanding of anaemia was associated with maternal age over 30 years (p < 0.05) and maternal education level beyond grade ten (p < 0.001). In contrast, higher knowledge of symptoms of anaemia was associated with maternal employment (p < 0.01).ConclusionsThe knowledge of anaemia and awareness of thalassaemia among mothers was poor. Very few mothers were aware of iron-rich food and feed it to their children. Despite being located in a thalassaemia-endemic region, very few knew that thalassaemia is a cause of anaemia and have got themselves screened for thalassaemia.

Risk Grubu Ergenlerde Sağlıklı Yaşam Biçimi Davranışları ve Benlik Saygısı Üzerine Bir Değerlendirme

Introduction: The basis of healthy life style behaviors and self-esteem are laid in adolescence and they become permanent factors affecting the life of the individual. Therefore, it is important to evaluate healthy lifestyle behaviors and self-esteem in adolescence. This study was conducted todetermine the level of healthy lifestyle behaviors and self-esteem and the factors affecting these levels in young people who continue adolescence, which is a critical period in human life, in the working environment. Material and Method: The study was designed as a descriptive research. The population of there searchconsists of 109 adolescents between the ages of 14-18 who study at the Vocational Apprenticeship and Training Center affiliated to the Provincial Directorate of NationalEducation in Zonguldak City Center. Introductory Information Form, in which personal data were questioned, Healthy Life Style Behaviour Scale II and Rosenberg Self-Esteem Scale were used in the study. Results: 88.5% (92) of the participants were male and 11.5% (12) were female. It was determined that there was a significant difference between maternal education level (p=.011) and physical self-liking (p=.012) and the mean score of the Healthy Life Style Behaviors Scale II. The difference between the physical self-esteem and the Rosenberg Self-Esteem Scalemean score was found to be significant (p=.002). Discussion: As a result of the Pearson correlation analysis of the relationship between the Healthy Life Style Behaviour Scale II and Rosenberg Self-Esteem Scale scores with each other and other individual characteristics, it was determined that there was a positive (Rosenberg Self-Esteem Scale score is calculated negative) and a moderate (p=.006) relationship between th emean scores of Healthy Life Style Behaviour Scale II and Rosenberg Self-Esteem Scale. Key words: Adolescent; healthy lifestyle; self-esteem

Knowledge, attitudes and practices on menstrual hygiene and associated factors among grade 10 schoolgirls in the district of Kalutara, Sri Lanka

Introduction: Menstruation is a natural phenomenon that occurs with sexual maturity of females. However, the topic is taboo for most female adolescents leading to improper practices on menstrual hygiene (MH) management. Objectives: To assess the knowledge, attitudes and practices on MH and associated factors among Grade 10 adolescent girls in Kalutara District, Sri Lanka Methods: A descriptive cross-sectional study was conducted. The final sample size computed was 720, applying a design effect of 3.8. As the cluster size decided was 15, 48 clusters/classes were selected using multi-stage stratified cluster sampling applying probability sampling techniques. A validated self-administered questionnaire was administered using Sinhala and Tamil versions. Bivariate and multivariate logistic regression was conducted to determine the associated factors. Results: Response rate at the time of recruitment was 100%. Satisfactory level of overall knowledge was observed in 25% (95% CI: 21.9, 28.3), attitudes in 67.2% (95% CI: 64.0, 70.9) and practices in 17.3% (95% CI: 14.7, 20.3). Unsatisfactory knowledge was associated with menstrual information not provided by a science teacher (ScT) (p&lt;0.001) school types 1C and 2 combined (p=0.002) and mothers having less than tertiary education (p=0.03). Unsatisfactory attitudes were associated with menstrual information not provided by a ScT (p&lt;0.001) and lack of premenarcheal awareness (p=0.009). Unsatisfactory practices were associated with school types IC and 2 combined (p&lt;0.001), residing in urban sector (p=0.004) and having extended families (p=0.034). Conclusions &amp; Recommendations: Overall knowledge on menstruation and menstrual hygiene related practices were poor, whereas attitudes were satisfactory. School type, maternal educational level, lack of premenarcheal awareness, menstrual information not being provided by a science teacher, residing in urban sector and living with extended family were the factors associated with unsatisfactory knowledge, attitudes and practices.

Obesity, overweight and hyperglycemia among primary school children in a low-middle income country with a multiethnic population

ObjectiveThe number of children with cardiovascular risk factors is increasing steadily. However, limited data are available on the prevalence of overweight, obesity, and hyperglycemia among children in low-middle-income countries with multiethnic populations. Therefore, we assessed these factors in a school-based survey in Suriname, a low-middle-income country. MethodsWe invited pupils of 5th and 6th grade visiting the primary school to participate in this survey. We used a questionnaire and face to face interviews, and conducted measurements to collect data on biological factors (ethnicity, sex, length, weight, waist circumference, and fasting blood glucose levels), behavior (frequency of physical activity, breakfast, bedtime, screentime), consumption (fruit and vegetables, snack, dairy products) and social factors (parental education, living area). ResultsOverall, the percentage of children with overweight was 13.9%, obesity 13.3% and for elevated fasting blood glucose level (> 6 mmol/L) 4.5%. In the investigated group of individuals, obesity and overweight were associated with sex (girls showed a lower OR of 0.54 [95%CI: 0.39–0.75] for obesity), ethnicity (Javanese 2.1, 1.5–3.0 for overweight and 5.0, 3.1–8.2 for obesity, Maroon 2.2, 1.2–4.1 and Mixed ethnicity 1.7, 1.1–2.6, for obesity compared to Hindustani), behavior (Skip Breakfast: 1.4, 1.2–1.7, physical activity: 0.8, 0.7–0.9) and maternal education level (high 1.7, 1.0–2.7). Children with elevated fasting blood glucose levels showed an association with obesity (1.8, 1.2–2.7) and waist circumference (1.02, 1.01–1.03). ConclusionThe results show that there is a high prevalence for overweight, obesity and elevated fasting blood glucose among children in Suriname. Furthermore, during childhood ethnicity is associated with obesity and overweight. We suggest that the modifiable risk factors such as BMI, WC, behavior, consumption are interesting for early intervention in children in a developing country.

PFAS levels and exposure determinants in sensitive population groups

BackgroundPer- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants. The first exposure to PFAS occurs in utero, after birth it continues via breast milk, food intake, environment, and consumer products that contain these chemicals. Our aim was to identify determinants of PFAS concentrations in sensitive population subgroups– pregnant women and newborns. MethodsNine European birth cohorts provided exposure data on PFAS in pregnant women (INMA-Gipuzkoa, Sabadell, Valencia, ELFE and MoBa; total N = 5897) or newborns (3xG study, FLEHS 2, FLEHS 3 and PRENATAL; total N = 940). PFOS, PFOA, PFHxS and PFNA concentrations were measured in maternal or cord blood, depending on the cohort (FLEHS 2 measured only PFOS and PFOA). PFAS concentrations were analysed according to maternal characteristics (age, BMI, parity, previous breastfeeding, smoking, and food consumption during pregnancy) and parental educational level. The association between potential determinants and PFAS concentrations was evaluated using multiple linear regression models. ResultsWe observed significant variations in PFAS concentrations among cohorts. Higher PFAS concentrations were associated with higher maternal age, primipara birth, and educational level, both for maternal blood and cord blood. Higher PFAS concentrations in maternal blood were associated with higher consumption of fish and seafood, meat, offal and eggs. In cord blood, higher PFHxS concentrations were associated with daily meat consumption and higher PFNA with offal consumption. Daily milk and dairy consumption were associated with lower concentrations of PFAS in both, pregnant women and newborns. ConclusionHigh detection rates of the four most abundant PFAS demonstrate ubiquitous exposure of sensitive populations, which is of concern. This study identified several determinants of PFAS exposure in pregnant women and newborns, including dietary factors, and these findings can be used for proposing measures to reduce PFAS exposure, particularly from dietary sources.

Effects of fine ambient particulate matters on de novo hypertensive disorders of pregnancy and blood pressure before 20 weeks

The effects of fine particulate matter (PM) on de novo hypertensive disorders of pregnancy (HDP) were inconsistent during the first and second trimesters. This study aimed to assess the trimester-specific effects of PM2.5 and PM1 prior to diagnosis of de novo HDP. The exposure of fine PM was predicted by satellite remote sensing data according to maternal residential addresses. De novo HDP was defined as gestational hypertension and preeclampsia during the current pregnancy. A logistic regression model was performed to assess the association of PM2.5 and PM1 with HDP during the first and early second trimesters (0–13 weeks and 14–20 weeks). The generalized estimating equation model was conducted to assess the effect of PM2.5 and PM1 on blood pressure. The present study included 22,821 pregnant women (mean age, 29.1 years) from 2013 to 2017. PM2.5 and PM1 were significantly associated with an increased risk of de novo HDP during the first trimester (OR = 1.070, 95% CI: 1.013–1.130; OR = 1.264, 95% CI: 1.058–1.511 for per 10 μg/m3) and early second trimester (OR = 1.045, 95% CI: 1.003–1.088; OR = 1.170, 95% CI: 1.002–1.366 for per 10 μg/m3). Significant trends of increased de novo HDP risk was also observed with the increment of PM (all P for trend <0.05). The stratified analyses demonstrated that the associations between exposure to fine PM and the risk of HDP were more pronounced among the pregnant women with maternal age above 35 and low maternal education level (all OR >1.047). Each 10 μg/m3 increase of PM1 and PM2.5 before diagnosis of de novo HDP elevated 0.204 (95% CI: 0.098–0.310) and 0.058 (95%CI: 0.033–0.083) mmHg of systolic blood pressure. Exposure to PM2.5 and PM1 during the first and early second trimester were positively associated with the risk of de novo HDP. The fine PM before diagnosis of de novo HDP elevated the systolic blood pressure.

Relación entre los síntomas de déficit de atención/hiperactividad y el sueño en preescolares

IntroductionSleep problems are frequent in children with attention-deficit/hyperactivity disorder (ADHD). Some authors have tried to characterize paediatric sleep habits in Portugal, but none has focused on preschool-age children nor attempted to establish their association with ADHD. We aimed to assess the prevalence of ADHD symptoms in preschool-age children and to study their association with sleep habits. Material and methodsWe conducted a cross-sectional study. We distributed questionnaires to a random sample of caregivers of children enrolled in early childhood education centres in Porto. We collected data on sociodemographic characteristics, television watching and outdoor activities. We assessed ADHD symptoms and sleep habits with the Portuguese versions of the Conners’ Parents Rating Scale, Revised and the Children's Sleep Habits Questionnaire (CSHQ-PT), respectively. ResultsThe study included 381 preschoolers (50.90% male). We found high scores for ADHD symptoms in 13.10%, with a higher prevalence in girls (14.40% vs. 11.85%; P=.276). In the CSHQ-PT, 45.70% of participants had a mean total score greater than 48, which is the cut-off point applied in the screening of sleep disturbances in the Portuguese population. There was a significant association between high scores for ADHD symptoms and a lower maternal education level (P<.001), a shorter sleep duration (P=.049), and higher scores on parasomnias (P=.019) and sleep disordered breathing (P=.002) in CSHQ-PT subscales. ConclusionsADHD and sleep disorders are common in preschoolers, in Porto, and this study suggests some clinical correlations between them. Since these interactions are complex and far from being elucidated, further studies are paramount to provide guidance for prevention and managing strategies in younger children at risk for ADHD.

Individual and Neighborhood Characteristics Associated With Confirmatory and Follow-up Blood Lead Testing Among Children With Elevated Blood Lead Levels.

The aim of this study was to assess the proportions and likelihood of children who receive confirmatory and follow-up blood lead testing within the recommended time frames after an initial capillary elevated blood lead level (EBLL) and confirmed EBLL, respectively, by individual and neighborhood-level sociodemographic characteristics. We linked and used blood testing and sociodemographic characteristics data from a Pennsylvania birth cohort including children born between 2017 and 2018. Generalized linear mixed models were constructed to examine the associations between sociodemographic factors and having recommended confirmatory and follow-up testing. A population-based, retrospective cohort study. In this birth cohort, children who underwent at least 1 BLL test were followed up to 24 months of age. Children with a first unconfirmed (n = 6259) and confirmed BLL (n = 4213) ≥ 5 μg/dL were included in the analysis. Children had confirmatory and follow-up testing within the recommended time frames. Of the children with unconfirmed and confirmed EBLLs, 3555 (56.8%) and 1298 (30.8%) received confirmatory and follow-up testing, respectively. The proportions of the 2 outcome measures were lower among children experiencing certain sociodemographic disadvantages. In the univariate analyses, lower initial BLLs, older age, non-Hispanic Blacks, lower maternal educational levels, maternal Medicaid, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment, maternal smoking, and higher quartiles of neighborhood poverty and old housing were associated with lower odds of having confirmatory and follow-up testing. However, in multivariate models, children with lower initial BLLs, older age, maternal smoking, and non-Hispanic Blacks were significantly less likely to have confirmatory and follow-up testing. There were deficiencies in having recommended confirmatory and follow-up blood lead testing among children, especially those with sociodemographic disadvantages. Public health agencies and stakeholders should finetune policies to improve follow-up testing in conjunction with primary and secondary preventions for early detection and reduction of lead exposure among targeted children at risk of lead poisoning.

Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies

Existing evidence on the effects of race and ethnicity on pregnancy outcomes is restricted to individual studies done within specific countries and health systems. We aimed to assess the impact of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries, and to ascertain whether the magnitude of disparities, if any, varied across geographical regions. For this individual participant data (IPD) meta-analysis we used data from the International Prediction of Pregnancy Complications (IPPIC) Network of studies on pregnancy complications; the full dataset comprised 94 studies, 53 countries, and 4 539 640 pregnancies. We included studies that reported perinatal outcomes (neonatal death, stillbirth, preterm birth, and small-for-gestational-age babies) in at least two racial or ethnic groups (White, Black, south Asian, Hispanic, or other). For our two-step random-effects IPD meta-analysis, we did multiple imputations for confounder variables (maternal age, BMI, parity, and level of maternal education) selected with a directed acyclic graph. The primary outcomes were neonatal mortality and stillbirth. Secondary outcomes were preterm birth and a small-for-gestational-age baby. We estimated the association of race and ethnicity with perinatal outcomes using a multivariate logistic regression model and reported this association with odds ratios (ORs) and 95% CIs. We also did a subgroup analysis of studies by geographical region. 51 studies from 20 high-income and upper-middle-income countries, comprising 2 198 655 pregnancies, were eligible for inclusion in this IPD meta-analysis. Neonatal death was twice as likely in babies born to Black women than in babies born to White women (OR 2·00, 95% CI 1·44-2·78), as was stillbirth (2·16, 1·46-3·19), and babies born to Black women were at increased risk of preterm birth (1·65, 1·46-1·88) and being small for gestational age (1·39, 1·13-1·72). Babies of women categorised as Hispanic had a three-times increased risk of neonatal death (OR 3·34, 95% CI 2·77-4·02) than did those born to White women, and those born to south Asian women were at increased risk of preterm birth (OR 1·26, 95% CI 1·07-1·48) and being small for gestational age (1·61, 1·32-1·95). The effects of race and ethnicity on preterm birth and small-for-gestational-age babies did not vary across regions. Globally, among underserved groups, babies born to Black women had consistently poorer perinatal outcomes than White women after adjusting for maternal characteristics, although the risks varied for other groups. The effects of race and ethnicity on adverse perinatal outcomes did not vary by region. National Institute for Health and Care Research, Wellbeing of Women.

Factors Analisys of the Event of Premature Rupture of Membranes with Mothers in Labor During a Pandemic Covid 19

Premature rupture of membranes (PROM) is the rupture of the membranes before delivery. The incidence of PROM in the world is still high, at 50-60%, while in Indonesia, it is around 65%. Various factors cause PROM that needs to be known so that mothers with PROM can be treated appropriately, namely age, parity, education, infection, and history of PROM. This study aimed to determine the frequency distribution and the relationship of age, parity, education, infection, and history of PROM with the incidence of PROM in women giving birth during the Covid-19 pandemic at RS Sentosa Bogor in 2022. This  research methodology is analytic observational with a case control research design. The study was conducted at Sentosa Hospital, Bogor, from May to July 2022. This study's population is mothers giving birth at Sentosa Hospital in 2022. The research sample amounted to 108 people with a total sampling technique. The data in the study were carried out by univariate and bivariate analysis using chi-square statistical tests and computerized programs. The results showed that there was a relation between the incidence of PROM in the mother with knowledge (p 0.020), anemia (p 0.015)  parity one and &gt;3 (p-value 0.009), infection (p-value 0.037), and history of PROM (p-value 0.005). Meanwhile, there is no relationship between maternal education level (p-value 0.546) and the incidence of PROM in pregnant women. Age, parity, infection, and history of PROM are factors in the occurrence of PROM in pregnant women. It is hoped that there will be counseling for prospective mothers regarding  PROM  to avoid the occurrence of PROM in pregnant women.

Factors associated with breastfeeding duration among women in Sarajevo Canton, Bosnia and Herzegovina

Breastfeeding is the optimal method of infant feeding bringing short-and long-term benefits for infants, mothers, environment, economy and the entire society. A variety of factors influence and determine breastfeeding duration, including characteristics of the mother, the child and the family, aspects of the health care system, public health and social policies, advertising and promotion of alternative feeding methods. This study aimed to investigate the factors which are associated with breastfeeding duration in a sample of mothers living in Sarajevo Canton, Bosnia and Herzegovina. This cross-sectional study was carried out at the Pediatric Outpatient Department of the Public Institution Primary Health Care Centre of Canton Sarajevo. The study evaluated 150 mothers in three groups according to breastfeeding duration of 50 each (i.e. less than 3 months, 3–5 months and 6 months and more). As an instrument for data collection a questionnaire was used to provide sociodemographic data, information about mother’s health during pregnancy, delivery in baby-friendly hospital and breastfeeding duration. The results of logistic regression analysis showed that delivery in baby-friendly hospital had a significant association with breastfeeding duration of 6 months and more (p=0.023). Maternal age (p=0.873), marital status (p=0.628), maternal education level (p=0.228), maternal employment (p=0.949), self-perceived financial status (p=0.189), maternal health during pregnancy (p=0.874) were not significantly associated with breastfeeding duration of 6 months and more. These results support the importance of the hospital environment and health provider practices in breastfeeding promotion.

Factors Affecting Non Compliance with Exclusive Breastfeeding Among Mothers: A Survey at District Hospital Dadu

Background: According to standard guideline for breastfeeding, t is mandatory to practice exclusive breastfeeding during the first six months of a baby's life to provide the finest physiological support for all neonates. In Pakistan there is visible underuse of exclusive breastfeeding among lactating mothers. This study aims to assess the variables affecting the non-compliance to exclusive breastfeeding among mothers at a district hospital in Pakistan. Materials and methods: A descriptive cross sectional study design was conducted to in Pediatric OPD at the district hospital Dadu from January to June 2022, breast feeding mothers were the study population, Using a total population sampling method, 224 breastfeeding mothers were interviewed regarding their practice towards exclusive breast feeding. Chi square test of association was used to evaluate the association of variables. Results: We observed that only 29. 5% mothers practiced exclusive breast feeding. All the mothers in the study had a breastfeeding child. Most of the mothers in this study were aged between 20 to 40 years (62%). Nearly 2/3rd of the mothers in the study had no formal education, only 5.8% mothers had higher secondary education. More than 1/5th of the mothers had more than 5 children. The most common reason for non-compliance with the exclusive breastfeeding was the use of formula milk by the mothers followed by insufficient breast milk Conclusion: Inclination to use formula milk, insufficient breast milk, early weaning and lack of the education among mothers were most common causes of non-compliance towards exclusive breastfeeding. Maternal education level was significantly associated with exclusive breastfeeding. Mass level health education for maternal and child health are recommended. Keywords Breast feeding, Exclusive breastfeeding, Neonate, Maternal factors,

Verbal fluency in Lebanese children: Preliminary normative data, sociodemographic determinants, and patterns of clustering and switching

This study assessed the quantitative and qualitative performance of Lebanese-speaking children on verbal fluency (VF) tasks and investigated the effects of sociodemographic characteristics. This study included 219 Lebanese children aged between 5 and 12 years and 11 months, whose native language is Lebanese-Arabic. Semantic and letter VF tasks were assessed using a range of categories and letters. Switching and clustering strategies were analyzed for 177 Lebanese children. The number of words produced presented a significant increase with age (p < .004) in semantic (SVF), while in letter (LVF), the differences were significant between extreme age groups. Females generated more words in the clothes (p = .003) and household items (p = .002) categories. The total number of switches and clusters showed a significantly increasing pattern with age (p < .05). The number of switches was higher for participants with high maternal (p < .001) and paternal (p < .013) educational levels. Regression analyses showed that the total number of switches and clusters, and the mean cluster size had a significant effect on SVF performance (p < .001). The current study generated preliminary norms for VF tasks for Lebanese-speaking children. The results of the current study have an important contribution to neuropsychology research and clinical practice.

Night Sleep and Parental Bedtime Practices in Low-Risk Preterm and Full-Term Late Talkers.

Night sleep and parental bedtime practices have rarely been investigated in late talkers. This study aimed to explore: night sleep, parental bedtime practices, and their associations in late talkers as well as individual, socio-demographic, and socio-relational factors affecting them. Parents of 47 30-month-old late talkers, born low-risk preterm (n = 24) or full-term (n = 23), with an expressive vocabulary size ≤10th percentile measured by the MacArthur-Bates Communicative Development Inventory Words and Sentences, and normal cognitive abilities measured by the Bayley Scales, completed the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behaviour Scale, and the Parenting Stress Index Short Form. Results showed slight settling difficulties, night wakings, and frequent co-sleeping in late talkers. Encouraging autonomy practices were frequently used by parents, rather than active physical comforting ones. Recurrent settling difficulties were reported by parents who often applied encouraging autonomy practices, whereas greater night waking problems and frequent co-sleeping were reported by parents who often left their child crying. Low-risk preterm birth and mother's parenting stress predicted total sleep difficulties and night wakings; first-born, high maternal education level and mother's parenting stress predicted settling difficulties; mother's parenting stress was the only predictor for co-sleeping and leaving to cry. These findings have relevant implications for improving late talkers' night sleep and their parents' bedtime practices.

Association between isolated maternal hypothyroxinemia during the first trimester and adverse pregnancy outcomes in Southern Chinese women: a retrospective study of 7051 cases

BackgroundThe association between isolated maternal hypothyroxinemia (IMH) and adverse pregnancy outcomes is still controversial. This study aimed to evaluate the association between IMH during the first trimester and adverse pregnancy outcomes in southern Chinese women.MethodsThis was a hospital-based, retrospective cohort study. The records of 7051 women, including 1337 IMH women and 5714 euthyroid women who had a singleton pregnancy and accepted routine prenatal service at the Third Affiliated Hospital of Sun Yat-Sen University from January 2015 to September 2018, were extracted from the electronic medical records system in this study. Thyroid functions [thyroid-stimulating hormone (TSH), free thyroxine (fT4) and anti-thyroperoxidase autoantibody (TPO-Ab)] had to be measured before 13 weeks and 6 days of gestation. The chi-square test and multivariate logistic regression analysis were applied to evaluate the association between IMH during the first trimester and adverse pregnancy outcomes.ResultsPrepregnancy obesity [prepregnancy body mass index (preBMI) ≥ 25 kg/m2] was found to be more common in the IMH group (11.2% vs. 6.1%) (P < 0.05). The prevalence of gestational diabetes mellitus (GDM), postpartum haemorrhage (PPH), macrosomia and large for gestational age (LGA) was higher in the IMH group. However, after using multivariate logistic regression analysis to adjust for confounders (maternal age, educational levels and preBMI), only LGA was shown to be associated with an increased risk in IMH women [adjusted OR: 1.27 (95% CI 1.044–1.566)]. The prevalence of preterm delivery (either < 37 or < 34 weeks), gestational hypertension, preeclampsia, placenta previa, placental abruption, premature rupture of membrane (PROM), intrauterine growth restriction (IUGR), polyhydramnios, stillbirth, small for gestational age (SGA) and low Apgar score did not increase.ConclusionIMH during the first trimester did not increase any risk of adverse pregnancy outcomes in southern Chinese women except LGA.

Free sugar intake and associated factors among Sri Lankan preschool children

BackgroundExcessive free sugar intake tends to be associated with unpleasant health consequences, such as dental caries and unhealthy weight gain in children, as well as a number of noncommunicable diseases in adults. The WHO suggests that the best method for addressing these issues is to reduce free sugar consumption throughout life, in order to be successful, these measures should be implemented as early as possible. This makes the early formative years of preschool an important point for possible intervention. To confirm this, baseline information on current sugar intake levels is needed, as well as identification of factors associated with high levels of consumption.MethodsThis cross-sectional study was conducted in the district of Colombo, Sri Lanka. The probability proportionate to size technique combined with cluster sampling was used to select a representative sample of 813 children aged 4-5-years from 82 preschools. We developed, and validated a quantitative food frequency questionnaire (FFQ) to assess free sugar consumption. Data on correlated factors were collected from caregivers using a pre-tested self-administered questionnaire.ResultsBased on the data, the daily median (IQR) free sugar intake of preschool children was 57.9 (33.2-95.8) grams/day (approximately to 14.5 (8.3-23.9) teaspoons/day) or 21.1% (12.5-34.9%) of their daily energy requirements. The WHO recommends limiting sugar intake to less than 5% of total energy intake; however, the current level is fourfold, and 96% of children consume higher percentage of energy from free sugar than recommended. In terms of total daily sugar consumption, bakery products accounted for 27%, followed by biscuits (15%), and table sugar (15%). Increasing maternal education level significantly reduced sugar intake (p = 0.04). Children of other ethnicities ate more sugar than the Sinhala children (p = 0.01). There was higher sugar intake among those who ate while returning from preschool (p < 0.001), while watching television (p < 0.001), and those who had school-going siblings (p = 0.02).ConclusionAmong preschool children, free sugar consumption levels were very high and most of the children consumed more sugar than is recommended; which warranted urgent actions to curb sugar intake among them.

Association between parental occupations, educational levels, and household income and children's psychological adjustment in Japan

ObjectivesMost research on the association between parental or family socio-economic status and psychological adjustment in children has been performed mainly in Western countries, while there is limited evidence of such research in Asian countries. We examined the association of parental occupation and educational levels and household income with children's psychological adjustment in Japan. Study designThis was a cross-sectional study. MethodsStudy subjects were 6329 children aged 3 years. Children's psychological adjustment was assessed using the Strengths and Difficulties Questionnaire. ResultsCompared with having an unemployed father, having a father who worked in an administrative and managerial or clerical job was associated with a lower prevalence of peer problems. Compared with having an unemployed mother, having a mother who worked in the professional and engineering, sales, service, or manufacturing process area was associated with a lower prevalence of low prosocial behaviors, whereas having a mother who worked in the clerical, service, or manufacturing process area was associated with an increased prevalence of emotional problems. Having a mother who worked in a clerical area was associated with a higher prevalence of conduct problems. Higher paternal and maternal educational levels were inversely associated with the prevalence of conduct problems and hyperactivity but were positively associated with low prosocial behaviors. A higher household income was inversely associated with the prevalence of emotional problems, conduct problems, and hyperactivity. ConclusionParental occupation, educational levels, and household income may affect children's psychological adjustment in Japan.

Is Parental Mathematics Anxiety Associated with Young Children’s Arithmetical Performance?

It has been suggested that parental mathematics anxiety may influence their children’s mathematics anxiety, attitudes, and performance. It remains an open question whether these parent-child associations differ by parental sex or parental involvement. We tested 249 Dutch-speaking Belgian participants, forming 83 (biological) mother–father–child trios. The 83 children (age: M = 5.74; SD = 0.30) attended Kindergarten. We tested their nonsymbolic comparison, symbolic numerical magnitude processing, numeral recognition, arithmetic, and matrix reasoning. We assessed both parents’ arithmetic skills, math anxiety, educational level, and division of care. More math-anxious parents tended to be less highly educated (r~0.42) and poorer at math (r~0.30). Compared to fathers, mothers had lower arithmetic, higher math anxiety, and higher educational level. Assortative mating (i.e., a significant spousal correlation) was found for educational level and arithmetic. Mothers’ (but not fathers’) educational level predicted children’s arithmetic scores (r = 0.31). Other parent-offspring correlations were non-significant. Most of the children’s test scores are intercorrelated. The parental characteristic that best predicted five- and six-year-olds’ arithmetic performance was maternal educational level rather than mathematical anxiety or performance. We discuss these findings in relation to the used measures, parental gender and involvement, children’s age, statistical power, and genetic and environmental transmission. The field is just starting to understand whether and how mathematics anxiety and the skills of parents influence those of their offspring.