Maternal Education Status Research Articles

Factors consistently associated with utilisation of essential maternal and child health services in Nigeria: analysis of the five Nigerian national household surveys (2003–2018)

ObjectiveThis study aims to identify the individual and contextual factors consistently associated with utilisation of essential maternal and child health services in Nigeria across time and household geolocation.Design, setting and...

Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2-5 Years from Delivery.

Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2–5 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2–5 years from delivery (p < 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2–5 years (p < 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2–5 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p < 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented.

Assessment Level of Knowledge about Supplementary Polio Immunization in Mothers Presenting to Pediatric Population

Introduction: Humans are the only known reservoir of polio virus. Polio virus infection in humans can cause a crippling paralysis in a fraction of the infected patients. Due to permanent nature of the paralysis, low mutation rate of the virus, restriction of polio virus to human hosts and overall feasibility of polio eradication, the polio virus became the target of aggressive vaccination campaigns via supplemental polio immunization (SPI) across the world for more than two decades. To determine the level of knowledge about supplementary polio immunization in mothers presenting to pediatric Population. Materials and Methods: This study was conducted in the Pediatric Department, OPD, District General hospital Timergara from 29-04-2021 to 29-7-2022. Through a descriptive, cross-sectional study design, 216 mothers of children aged 0-5 years, accompanying their children to the pediatric OPD, were included in the study through a consecutive manner and interviewed using a structured questionnaire. Results: In this study 216 mothers were included. Mean age of the mothers was 30.97 years. Most mothers had average level of knowledge (48.6%) while 30.6% had poor level of knowledge regarding supplementary polio immunization. Most common religion was Islam (96.3%). Illiteracy was the most common educational status (32.9%) followed by secondary (22.7%) and primary (19.4%) education. Majority (58.8%) of mothers were housewives. Pearson Chi Square test for Level of Knowledge wise stratification of Educational Status of the mother gave a value of 2=45.793 and was significant at p&lt;0.05. Level of Knowledge wise stratification of Religion of the mother had 9 cells (75%) with expected count less than 5. Level of Knowledge wise stratification of Occupational status of the mother had 2=10.148 with p=0.11(i.e.&gt;0.05). Finally, the Level of Knowledge wise stratification of Age groups of mothers had 2=2.87 with p=0.94(i.e. &gt;0.05). Conclusion: Level of Knowledge of mothers regarding supplementary polio immunization is significantly associated with maternal educational status Keywords: Polio, supplementary polio immunization, polio drops

Under-Nutrition and Associated Factors Among Lactating Mothers in Ethiopia: A Systematic Review and Meta-analysis.

Under-nutrition (body mass index < 18.5kg/m2) is a global problem with an increasing trend in recent years. The burden is high in low and middle-income countries, especially in Africa. Lactating mothers are among the most vulnerable groups for under nutrition; particularly in sub-Saharan Africa. In Ethiopia, the prevalence of under-nutrition among this group is inconsistent and inconclusive. Therefore, we aimed to assess the pooled prevalence of under-nutrition and its associated factors among lactating mothers in Ethiopia. To write this review and meta-analysis, we followed the preferred reporting items for systematic review and meta-analysis guidelines. Primary articles were searched from PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar. STATA version 16 software and a standardized Microsoft excel format were used for analysis and data extraction, respectively. Heterogeneity between studies was checked. To determine the pooled prevalence of under-nutrition, we used a random-effect model. Begg's and Egger's tests were done to detect publication bias. Subgroup analysis was also steered and association was uttered by a pooled odds ratio with 95% CI. The pooled prevalence of under-nutrition among lactating mothers was 23.84% [95% CI (19.40, 28.27)]. Educational status (no formal education) {Pooled OR 2.30 [95% CI (1.34, 3.96)]} was significantly associated with under-nutrition. The pooled prevalence of under-nutrition was high. Maternal educational status was significantly associated with under-nutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups and strengthen the implementation of the previously designed strategies.

Does Therapeutic Zinc Level of Supplementation for Diminutions of Acute Diarrheal Morbidity Varied in Public and Private Health Institutions in Ethiopia, Data from EDHS 2016?

Background Supplementation of zinc is a therapeutic medication for under-five children diminution incidence, severity, duration, and intensity of acute diarrhea morbidity. Nevertheless, levels of therapeutic zinc supplementation varied across public and private health institutions in Ethiopia. Thus, this study was aimed at estimating the levels of therapeutic zinc supplementation and factors associated for intent to be utilized among caregivers with their dyads, data from Ethiopia Demographic and Health Survey (EDHS 2016). Methods The data used were from a secondary analysis of the Ethiopia Demographic and Health Survey in 2016 (EDHS). Overall, 1090 under-five children with acute diarrheal cases of two weeks before the EDHS 2016 were included. After cleaning, editing, and coding variables, the result was presented with frequency, tables, and graphs. Bivariable and multivariable logistic regression was conducted to identify and determine factors associated after zinc is prescribed for utilizations by caregivers. Result The mean (±SD) age of participant children was found to be 36.4(±7.07) month. The overall levels of therapeutic zinc supplementation were 38.7% (95% CI: 35.8, 41.6) in public (29.08%) and private 138 (12.66%), respectively. The prescribed therapeutic zinc was influenced for utilization through maternal educational status (AOR = 2.55; 95% CI: 1.95, 3.47; P = 0.001), availability of health insurance (AOR = 10.7; 95% CI: 7.2, 16; P = 0.001), media exposure status (AOR = 2.1; 95% CI: 1.7, 3.6; P = 0.001). Conclusion More than twofold time therapeutic zinc was prescribed in public than in private health institutions. Health care workers should be encouraged both in public and private health institutions for zinc prescription.

Knowledge on anaemia and benefit of iron–folic acid supplementation among pregnant mothers attending antenatal care in Woldia town, Northeastern Ethiopia: a facility-based cross-sectional study

BackgroundAnaemia in pregnancy is the leading cause of maternal morbidity and mortality and poor birth outcomes in low- and middle-income countries. The most common cause of anaemia during pregnancy is acute blood loss and iron deficiency due to physiological changes and increasing demand for iron on the mother and growing foetus. Iron and folic acid supplementation is the most widely employed strategy to alleviate iron deficiency anaemia during pregnancy. The mother’s knowledge of anaemia and the benefit of iron–folic acid is crucial in reducing the magnitude of anaemia due to iron deficiency. In Woldia town, despite the efforts made to reduce iron deficiency anaemia during pregnancy, information on pregnant mother knowledge on anaemia and the benefit of iron–folic acid and its associated factors are scarce.MethodsA facility-based cross-sectional study design was conducted, on 414 pregnant mothers attending antenatal care in Woldia town, Northern Ethiopia. Systematic random sampling methods were used to select study participants. The data were entered into Epi-data version 4.2 and analysed using SPSS version 24. Bivariable and multivariable analysis was done to see the association between the dependent variable and independent variables.ResultsThis study revealed that 54.1% and 57.7% of pregnant women had good knowledge of anaemia and the benefit of iron–folic acid, respectively. Maternal education status (AOR = 2.19, 95% CI 1.32–3.64), good knowledge of iron–folic acid (AOR = 5.85, 95% CI 3.60–9.50) and residence (AOR = 5.43, 95% CI 2.36–12.51) were statistically associated with pregnant mothers knowledge on anaemia. Obtained counselling on the benefit of iron–folic acid (AOR = 2.04, 95% CI 1.11–3.75), having four or more antenatal care visit (AOR = 3.12, 95% CI 1.38–7.07) and good knowledge of anaemia (AOR = 5.88, 95% CI 3.63–9.50) was statistically associated with pregnant mothers knowledge on the benefit of iron–folic acid.ConclusionsPromoting frequent antenatal care visits and giving counselling on the benefit of iron–folic acid and cause, prevention and treatment of anaemia were essential strategies to raise knowledge of pregnant mother on anaemia and the benefit of iron–folic acid.

Associations of maternal glucose markers in pregnancy with cord blood glucocorticoids and child hair cortisol levels.

Exposure to maternal hyperglycemia in utero has been associated with adverse metabolic outcomes in offspring. However, few studies have investigated the relationship between maternal hyperglycemia and offspring cortisol levels. We assessed associations of gestational diabetes mellitus (GDM) with cortisol biomarkers in two longitudinal prebirth cohorts: Project Viva included 928 mother-child pairs and Gen3G included 313 mother-child pairs. In Project Viva, GDM was diagnosed in N = 48 (5.2%) women using a two-step procedure (50 g glucose challenge test, if abnormal followed by 100 g oral glucose tolerance test [OGTT]), and in N = 29 (9.3%) women participating in Gen3G using one-step 75 g OGTT. In Project Viva, we measured cord blood glucocorticoids and child hair cortisol levels during mid-childhood (mean (SD) age: 7.8 (0.8) years) and early adolescence (mean (SD) age: 13.2 (0.9) years). In Gen3G, we measured hair cortisol at 5.4 (0.3) years. We used multivariable linear regression to examine associations of GDM with offspring cortisol, adjusting for child age and sex, maternal prepregnancy body mass index, education, and socioeconomic status. We additionally adjusted for child race/ethnicity in the cord blood analyses. In both Project Viva and Gen3G, we observed null associations of GDM and maternal glucose markers in pregnancy with cortisol biomarkers in cord blood at birth (β = 16.6 nmol/L, 95% CI -60.7, 94.0 in Project Viva) and in hair samples during childhood (β = -0.56 pg/mg, 95% CI -1.16, 0.04 in Project Viva; β = 0.09 pg/mg, 95% CI -0.38, 0.57 in Gen3G). Our findings do not support the hypothesis that maternal hyperglycemia is related to hypothalamic-pituitary-adrenal axis activity.

The Co-Utilization of Oral Rehydration Solution and Zinc for Treating Diarrhea and Its Associated Factors Among Under-Five Children in Ethiopia: Further Analysis of EDHS 2016.

IntroductionDiarrhea causes a loss of body water and salt, which can lead to dehydration and death. The use of oral rehydration salts and zinc together is regarded as an effective treatment for diarrhea in resource-poor settings like Ethiopia. However, studies that examine the co-utilization of oral rehydration solution and zinc in the treatment of diarrhea are limited Ethiopia.ObjectiveTo assess the prevalence and associated factors of oral rehydration solution and zinc co-utilization to treat diarrhea in children under the age of five in Ethiopia, EDHS 2016.MethodsSecondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used to investigate the prevalence and factors associated with the co-utilization of ORS and zinc to treat diarrhea in under-five children. A multilevel binary logistic regression model was fitted to identify factors associated with the co-utilization of ORS and zinc. Adjusted odds ratios (AOR) with 95% CI were calculated and used as a measure of associations, and variables having a p-value of less than 0.05 were declared as statistically significant.ResultsThe national prevalence of ORS and zinc co-utilization was 16.65% (14.66%, 18.84%). Maternal educational status (AOR = 1.45; 95% CI; (1.01, 2.09)), household size (AOR = 1.53; 95% CI; 1.09, 2.16) and distance to health facilities at the community level (AOR = 1.60, 95% CI = 1.02, 2.58) were variables significantly associated with the co-use of ORS and zinc.ConclusionThe co-utilization of ORS and zinc for the management of diarrhea was low in Ethiopia. Education, household size, and distance to health facilities at the community level were significantly associated with the co-utilization of ORS and zinc in Ethiopia.

Prevalence and factors associated with Internet gaming disorder among adolescents in Saudi Arabia: A cross-sectional study.

This study aimed to assess the prevalence of internet gaming disorder (IGD) and its associated factors among a sample of adolescents in the Faifa governorate in the south of Saudi Arabia.This was a cross-sectional study targeting intermediate and secondary school adolescent students in the Faifa governorate. Multistage sampling was performed to reach the required sample, where 9 schools were randomly selected, followed by the distribution of the questionnaire to all students at all levels. IGD was assessed using a validated Arabic version of the 20-item IGD scale. A chi-square test was used to evaluate the presence of statistical differences between sample demographic data and IGD.Four hundred and fifty students participated in the current study, where 132 (29.3%) of them were classified as having IGD. The prevalence of IGD was associated with gender, year of study, maternal education status, and the number of hours spent online and playing with friends (P values 0.05). Analysis of the IDG items among the current sample indicated that most were at the conflict stage of IGD.The IGD level identified in our sample is high compared to the published literature. Faifa is a mountainous region and, due to its geographical nature, there are limited public entertainment areas. Adolescents tend to spend more time at home, where they may be more exposed to IGD. This suggests the need for strategies to ensure early identification of those at risk of IGD and to provide preventive and treatment options for these students.

Associated Factors of Wasting among Infants and Young Children (IYC) in Kuyu District, Northern Oromia, Ethiopia.

Wasting among infants and young children in underdeveloped countries including Ethiopia is one of the most serious public health issues. Therefore, this study was designed to assess the magnitude of wasting and the variables that associate with it among infants and young children in the Kuyu district of Northern Oromia, Ethiopia. A community-based cross-sectional study of 612 infants and young children aged 6-23 months was conducted. To select eligible infants and young children from each family in the Kuyu district, a multilevel sampling approach was used. The amount and determinants related to wasting were investigated using the Statistical Package for Social Sciences (SPSS) version 20.0. In the study area, 14.1% of infants and young children were found to be wasting. Maternal educational status (AOR = 1.8, 95% CI; 1.01, 4.32), diarrhoea (AOR = 2.3, 95% CI; 1.98, 4.56), exclusive breastfeeding (AOR = 2.46, 95% CI, 1.4, 4.58), antenatal care visits (AOR = 2.21; 95% CI, 1.32, 3.48), and wealth index (AOR = 1.66, 95% CI; 1.07, 4.47) were significantly associated with wasting. According to the findings of this study, mother educational status, the occurrence of diarrhoea, exclusive breastfeeding, antenatal care visits, and wealth index have an impact on infants and young children's wasting. Therefore, to lower the burden of wasting among infants and young children in the study, community-based schooling and nutritional interventions are urgently needed.

Co-existence of overweight/obesity and stunting: it’s prevalence and associated factors among under - five children in Addis Ababa, Ethiopia

BackgroundDouble burden of malnutrition is a global problem posing a serious public health challenge especially in low- and middle-income countries including Ethiopia, where a high prevalence of under-nutrition continues to exist and overweight is increasing at an alarming rate. Although both under-nutrition and over-nutrition are investigated extensively in Ethiopia, evidence about the double burden of malnutrition especially at the individual level is very limited.ObjectiveTo assess the prevalence of the co-existence of overweight/obesity and stunting and associated factors among under-five children in Addis Ababa, Ethiopia at an individual level.MethodsInstitution-based cross-sectional study was conducted from May to June 2021 among 422 mothers to child pairs in Addis Ababa. Twenty-nine (30%) of the health centers in Addis Ababa were selected to take part in the study using a simple random sampling technique. The total sample size was allocated proportionally to each of the selected health centers based on their performances within 6 months prior to the study. A systematic random sampling method was used to select the study participants. An interviewer-administered structured questionnaire was used to collect data. Descriptive statistics and a hierarchical logistic regression model were used to characterize the study population and to identify factors that are associated with the outcome variable respectively. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value less than 0.05.ResultsThe prevalence of the co-existence of overweight/obesity and stunting was 5.1% with 95% CI (2.9–7.1%). The hierarchical logistic regression analysis revealed that child age (6–23 months) [(AOR = 2.86, 95% CI: (1.02–8.04)], maternal education status (non-educated) [(AOR = 4.98, 95% CI: (1.33–18.66)], maternal age during birth (≥ 28 years) [(AOR = 0.22, 95% CI: (0.06–0.79)] and childbirth order (3+) [(AOR = 6.38, 95% CI: (1.03–39.7)] were significantly associated with the co-existence of overweight /obesity and stunting. Conclusion and recommendations: The study revealed that the prevalence of the co-existence of overweight/obesity and stunting is low in Ethiopia. However, local and national nutrition policies and programs should be tailored and implemented to simultaneously address both under-nutrition and over-nutrition.

Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries.

Introduction: Collective evidence on risk factors for dental caries remains elusive in low- and middle-income countries (LMICs). The objective was to conduct a systematic review and meta-analysis on risk factors for dental caries in deciduous or permanent teeth in LMICs. Methods: Studies were identified electronically through databases, including Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, PubMed/MEDLINE, and CINAHL, using “prevalence, dental caries, child, family, socioeconomic, and LMIC” as the keywords. A total of 11 studies fit the inclusion criteria. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale (NOS). The MedCalc software and Review Manager 5.4.1 were used. Results: From 11,115 participants, 38.7% (95% CI: 28.4–49.5%) had caries and 49.68% were female. Among those with caries, 69.74% consumed sugary drinks/sweets (95% CI: 47.84–87.73%) and 56.87% (95% CI: 35.39–77.08%) had good brushing habits. Sugary drinks had a two times higher likelihood of leading to caries (OR: 2.04, p < 0.001). Good oral hygiene reduced the risk of caries by 35% (OR: 0.65, p < 0.001). Concerning maternal education, only secondary education reduced the likelihood of caries (OR: 0.96), but primary education incurred 25% higher risks (OR: 1.25, p = 0.03). A 65% reduction was computed when caregivers helped children with tooth brushing (OR: 0.35, p = 0.04). Most families had a low socioeconomic status (SES) (35.9%, 95% CI: 16.73–57.79), which increased the odds of caries by 52% (OR: 1.52, p < 0.001); a high SES had a 3% higher chance of caries. In the entire sample, 44.44% (95% CI: 27.73–61.82%) of individuals had access to dental services or had visited a dental service provider. Conclusion: Our findings demonstrate that high sugar consumption, low maternal education, and low and high socioeconomic status (SES) increased the risk of dental caries in LMICs. Good brushing habits, higher maternal education, help with tooth brushing, and middle SES provided protection against caries across LMIC children. Limiting sugars, improving oral health education, incorporating national fluoride exposure programs, and accounting for sociodemographic limitations are essential for reducing the prevalence of dental caries in these settings.

Awareness of the mothers about Expanded Programme on Immunization and relation of immunization coverage with maternal education and Covid-19 Pandemic Lockdown

Background: Expanded Programme on Immunization (EPI) prevents childhood fatal illnesses, and better coverage will raise herd immunity. Objective: To assess the knowledge of the mothers about Expanded Programme on Immunization of childhood vaccinations and relationship of the immunization coverage with mother's education and Covid-19 pandemic lock-down. Methodology: It was a cross-sectional study, conducted by using a pretested questionnaire. Settings: Paediatric outpatient department and EPI centre, Sadiq Abbasi Hospital Bahawalpur from 1st September to 15th November 2021. A total of 200 multigravida mothers having children &lt;5 years, were included by convenient sampling technique. Data were collected through a proforma, containing information about demographic characteristics, EPI coverage of the child, and mothers' knowledge and attitude towards the EPI program. Data were analyzed with the help of SPSS version 21. Results: Among the total of 200 mothers, more than 90% were housewives and only 20% with more than 12 years of formal education. Only 3% of mothers answered correctly about the exact number of EPI vaccines. The awareness about the individual vaccine was 28% to 33%, except in the polio vaccine it was 70%, and in measles, it was 95%. Half of the mothers answered that EPI vaccines are safe, and half believe that they are effective as well. Working women and mothers with higher education status vaccinated themselves against covid-19 and also vaccinated their children according to the EPI schedule. Conclusion: Awareness regarding EPI is poor and maternal education status significantly affects EPI knowledge and practices, additionally covid-19 pandemic also affected the EPI practices.

Associations of Maternal and Child Fatty Acid Status With Child Growth and Development Outcomes in Ghana

ObjectivesMaintaining adequate fatty acid intake during pregnancy and lactation is necessary to support fetal and infant growth. Low maternal intake may lead to decreased transfer of fatty acids to the fetus. Our objective was to examine associations of individual fatty acid status at three different time points with child growth and development outcomes at 18 months. MethodsA cohort of 1,320 women were enrolled in the International Lipid-Based Nutrient Supplements Dyad Ghana trial (iLiNS-DYAD-G). Fatty acids were measured in maternal plasma at 36 weeks gestation (n = 130), maternal breast milk six months postpartum (n = 303), and child plasma at 18 months (n = 369) and quantified as weight percentage of total identified fatty acids of the sample (% weight). We examined correlations between time points (maternal, breastmilk, and child) for five indicators of fatty acid status: % weight of four individual fatty acids (alpha-linolenic acid, ALA; linolenic acid, LA; docosahexaenoic acid, DHA; arachidonic acid, AA) and the n6: n3 ratio (ratio of LA & AA to ALA, DHA & EPA). We then examined whether each fatty acid indicator was associated with child growth (head circumference for age, length for age, weight for length z-scores) or developmental outcomes (motor, language, and social-emotional scores) at 18 months. Adjusted regressions included child sex, food insecurity scores, socioeconomic status, intervention group, and years of maternal education. ResultsMaternal plasma and breast milk were positively correlated for % weight AA, LA, and n6: n3 ratio. Maternal and child plasma were positively correlated for % weight DHA and n6: n3 ratio. Breast milk and child plasma fatty acids were positively correlated for % weight AA, ALA, DHA, and n6: n3 ratio. Associations of fatty acid status indicators with child growth and developmental outcomes were not significant after correcting for multiple comparisons. ConclusionsAlthough maternal fatty acid status was associated with breastmilk and child fatty acid status, maternal and child fatty acid status was not generally associated with child growth and development at 18 months of age in this sample of mother-child dyads in Ghana. Funding SourcesBill & Melinda Gates Foundation; National Institute of Child Health and Human Development & Fogarty International Center R01HD099811.

Risk Factors of Autism Spectrum Disorders in Children

Objective: To find out demographical, medical, familial and parental risk factors of ASD in children. Study Design: Case-control study. Place and Duration of the Study: The department of Pediatric Neurology, The Children’s Hospital &amp; Institute of Child Health, Multan, Pakistan from November 2019 to April 2020. Methodology: A total of 120 children (60 cases and 60 controls) of both genders aged up to 12 years were enrolled. Diagnosis of ASD was made as per DSM-IV-TR criteria. Demographical and medical characteristics along with familial and parental data were noted. Chi-square test was employed considering p&lt;0.05 as significant to compare study variables between cases and controls. Results: In a total of 120 children, 72 (60.0%) children were male. Overall, mean age was noted to be 4.82±3.5 years while 77 (64.2%) children were ≤ 5 years of age. In comparison to controls, lack of breastfeeding up till 2 years of age (p=0.0009), asthma (p=0.0367), hearing impairment (p=0.0408) and allergy to milk or wheat (p=0.0475) were found to be significant risk factors among children with ASD while remaining all other characteristics were not found to have any significant relationship (p&gt;0.05) with ASD. It was observed that maternal education status as illiterate (p=0.0267) and immediate family history of ASD (p=0.0475) were significantly associated risk factors for ASD among cases wile all remaining factors were not found to have any significant association (p&gt;0.05). Conclusion: Lack of breastfeeding up till 2 years of age, presence of asthma, hearing impairment and allergy to milk or wheat were found to be significant risk factors among children with ASD. Maternal education status as illiterate and immediate family history of ASD were also noted to be significantly associated risk factors for ASD. Keywords: autism spectrum disorders, breastfeeding, asthma, hearing impairment, maternal education.

Risiko gizi lebih pada anak usia prasekolah berdasarkan aspek sosio-ekonomi keluarga di Kota Kediri

Overweight in children under five has increased and will impact at an early age and cause a metabolic syndrome in adulthood. Being overweight is caused by many things, one of which is socioeconomic family. Family socioeconomic is an underlying cause that influences feeding practices. This study aimed to analyze the risk of overweight in preschool children based on family socio-economics. This study used a case-control design conducted from December 2019 to March 2020. The sample used was 66 preschool children divided into two groups with a ratio of 1:1, which was carried out by simple random sampling—data collection techniques by interviewing sample mothers related to the socioeconomic aspects of the family. Data were processed using SPSS software and categorized each variable into two categories. Data analysis using Chi-Square test. The results of this study showed: that maternal nutritional knowledge was significantly correlated with the incidence of overweight in preschool children (p= 0,041). Other socio-economic aspects (maternal age (p= 0,202), paternal age (p= 0,250), maternal education (p= 0,450), paternal education (p= 0,301), family size (p= 0,439), and family economic status (p= 0,395) were not correlated with the overweight. This study concluded that maternal nutritional knowledge was one of the factors associated with overweight in preschool children, while other socioeconomic factors were not related.

The association between epidural analgesia during labor and mother-infant bonding

Study objectiveThis study was aimed to assess the association between the use of epidural analgesia during labor and mother-infant bonding. DesignA cross-sectional study. SettingMaternity ward at Soroka University Medical Center during 2020. PatientsWomen who delivered a singleton live-born infant vaginally in their immediate post-partum period. InterventionsWomen completed questionnaires. 25 items post-partum bonding questionnaire (PBQ) to assess mother-infant bonding (A high score on the PBQ indicates impaired mother-infant bonding) and the Edinburgh postnatal depression scale (EPDS) questionnaire to assess risk for post-partum depression. MeasurementsThe study used PBQ questionnaire and four sub-scales to assess mother-infant bonding and the EPDS questionnaire to assess risk for post- partum depression. Generalized linear regression models (gamma) were constructed to examine the association between epidural analgesia and mother-infant bonding total score and impaired bonding sub- scale, while adjusting for confounders Additional information such as pregnancy complications and sociodemographic data was drawn from women's medical records. Main resultsA total of 234 women were included in the final analysis, of them 126 (53.8%) delivered with epidural analgesia. The total PBQ score was significantly lower among women who received epidural analgesia compared to women without epidural analgesia (7.6 vs. 10.2, p = 0.024), demonstrating a better mother -infant bonding. Using two multivariable linear regression models, controlling for confounders such as maternal age and educational status, epidural analgesia during labor was independently associated with a better mother -infant bonding total score and better impaired bonding sub-scale score (Beta coefficient-0.252, 95% CI -0.5; −0.006, p = 0.045 and Beta coefficient − 0.34, 95% CI -0.52; −0.08, p = 0.01 for mother-infant bonding total score and sub-scale score, respectively). No differences in post-partum depression risks were found between the groups (EDPS≥13, 5.7% vs. 13%, p = 0.058). ConclusionOur study demonstrated better mother -infant bonding among women delivering with epidural analgesia.

Mental distress during the COVID-19 pandemic among mothers of young children and the related factors: A focus on their difficulties in raising their child, concerns about their child's development, social support, and capacity to receive support

Objectives We examined the relationships between the development of severe mental distress among mothers of young children during COVID-19 and the related factors including difficulties in raising child, concerns about child's development, social support, and capacity to receive support using comparable pre-COVID-19 baseline data. Severe mental distress was defined by a score of K6≧10 on the Psychological Distress Scale.Methods We conducted a baseline survey in February 2020 and obtained responses from 4,700 mothers of young children. A follow-up survey was conducted in June 2020. We obtained responses from 2,489 participants of the original group. The K6 scores (four groups) of two surveys were compared. Thereafter, 521 participants who had severe mental distress at the baseline were excluded, and 1,968 participants were included in the Poisson regression analysis. We adjusted for maternal age, education, marital and employment status, household income, children's age, number of children, and changes during COVID-19 pandemic. The adjusted incident rate ratios (IRRs) were estimated using K6≧10 at follow-up as the dependent variable, and the independent variables were having difficulty in raising a child, concerns about child's development, social support, and capacity to receive support.Results At the baseline, 20.9% of mothers had severe mental distress. At follow-up, this value increased significantly to 25.3%. Mothers who developed severe mental distress by the time of the follow-up survey were 333 (16.9%), and they were more likely to have had difficulty in raising their child, concerns about child's development, lower levels of positive attitudes toward receiving support (capacity to receive support), and lower levels of social support.Conclusions The mental health of mothers caring for young children worsened during the COVID-19 outbreak. Factors related to the development of severe mental distress included having difficulty in raising a child, concerns about child's development, and lower levels of positive attitudes toward receiving support (capacity to receive support) and lower levels of social support. Providing parenting support, consultation and rehabilitation, and exploring approaches to enhance capacity for receiving support are required.

Manifest anxiety and maternal–fetal attachment in pregnant women with previous fetal losses

ABSTRACT Aim To explore associations between manifest anxiety (Taylor’s Manifest Anxiety Scale, TMAS), major obstetric and demographic features and maternal-fetal attachment (MFA) (Maternal Antenatal Attachment Scale, MAAS) in women with previous miscarriages. Subjects and methods One hundred pregnant women with previous miscarriages, having uncomplicated singleton pregnancy, not receiving any medications, and conceived in a natural manner . Ages ranged between 19 and 47 years, gestational age between 4 and 35 weeks. Hierarchical multiple linear regression, Kruskal–Wallis test, and ANCOVA were used in data analysis. Results Maternal age, gestational age, previous abortions, parity, maternal education, and marital status in combination contributed significantly to the regression model in prediction of the MAAS quality and intensity scores. Adding the TMAS score accounted for an additional 17% of variation in the MAAS quality score, and the change in R 2 was significant. There was a negative relationship between the TMAS and the MAAS quality scores. The TMAS score did not contribute to prediction of the MAAS intensity. The highest TMAS values were in the women having anxious, ambivalent or affectless preoccupation. Conclusion Prevention of negative consequences of poor quality of MFA in women with previous miscarriages should include early screening for manifest anxiety.

Moderators of Food Insecurity and Diet Quality in Pairs of Mothers and Their Children.

Research has suggested that maternal diet and characteristics may influence the diet of offspring during childhood. The present cross-sectional study aimed to assess the influence of distinct maternal characteristics and the diet quality of mothers on the prevalence of household food insecurity (FI) and the diet quality of children. A total of 179 mother–child pairs were recruited from two primary schools in the metropolitan area of Thessaloniki. The children were aged between 10 and 12 years old. Diet quality was assessed as the level of adherence to the Mediterranean diet (MD), with the use of the KIDMED for the children and the MedDietScore for the mothers. The household FI and the social and demographic characteristics of the mothers were also recorded, and anthropometric measures of both the mothers and their children were collected. Approximately ¼ (26.3%) of the pairs reported some degree of FI, with a greater prevalence (64.7%) within single-mother families. Moreover, FI affected the level of maternal MD adherence (p = 0.011). On the other hand, FI was decreased in households with a greater maternal educational level (OR: 0.25; 95% CI: 0.10–0.63) and conjugal family status (OR: 0.15; 95% CI: 0.87–0.52). Maternal adherence to the MD was inversely related to the respective adherence of their offspring (OR: 0.93; 95% CI: 0.86–0.997), suggesting that during periods of financial constraints, maternal diet quality is compromised at the expense of affording a better diet for the minors in the family.