Maternal General Health Research Articles

The influence of maternal long term health conditions including multimorbidity on child oral health: A scoping review and evidence gap map protocol

Objective This scoping review will map the extent and type of evidence in relation to the association between maternal long term health conditions (LTCs), including multimorbidity, and child oral health. Introduction Newer theories are emerging that detail the many factors that can influence child oral health at child, family and community levels. More recently, the association between maternal general health and child oral health has been explored, with preliminary evidence suggesting a link between shared environmental factors and diet/substance use during pregnancy causing childhood caries. Inclusion criteria All published studies that describe the relationship between maternal LTCs (including multimorbidity) and child oral health. There will be no limitation on the date of publication due to the limited number of studies available from the initial search of PubMed. The review will exclude case studies, abstracts, and grey literature. Literature must be in English language. Methods The following databases will be searched; CINAHL, Cochrane Library, Maternity and Infant Care, Medline via PubMed, Scopus, Web of Science. The search will include sources in English only and will be undertaken between April and July 2024. Studies to be included will be of any type of study design that describe a relationship between maternal long term health conditions, including maternal long term oral health conditions, and child oral health. Data extraction will be undertaken using tabulation of results by at least two independent reviewers. Narrative analysis of the evidence will be undertaken, and results will be presented in a narrative and tabular manner due to the heterogenous and limited evidence base found in the test search. This review has been registered prospectively on Open Science Framework, (https://doi.org/10.17605/OSF.IO/ECSWJ). The review will also inform an Evidence Gap Map (EGM) to illustrate the current evidence base regarding maternal health factors that influence child oral health.

Ethnic-specific characteristics associated with longitudinal response patterns from prebirth to 12 years: evidence from Growing Up in New Zealand

BackgroundLongitudinal studies can generate valuable scientific knowledge, but can be compromised by systematic attrition. Previous research shows that sociodemographic characteristics (eg, ethnicity, age, educational level, socioeconomic circumstances) are associated with...

The Impact of Dietary Intake and Nutritional Status on Birth Outcomes Among Pregnant Adolescents: A Systematic Review

Birth outcomes have been linked to the overall maternal general health including nutrition as well as maternal age during pregnancy. Compared to adults, delivery outcomes during adolescence are poor. Nutrient intake and nutrition status during adolescent pregnancy may be linked to birth outcomes. This review aims to identify the association between dietary intake and nutrition status of pregnant adolescents and their maternofetal outcomes. Literature search on nutrient intake and nutritional status of pregnant adolescents (aged 11-19 years) which identified 17 English papers from 1995 to 2019 was reviewed. Papers that did not include data on birth outcomes in relation to nutrient intake or nutritional status were excluded. The review showed that most micronutrients with the exception of Riboflavin, vitamins B12 and C were below the recommended levels whilst macronutrients levels were above the recommended levels. Energy intakes were also below the recommended levels. Most studies presented normal hemoglobin levels in the first trimester of pregnancy but these levels decreased as pregnancy progressed to the third trimester leading to a high prevalence of anemia. Well-regulated provision and intake of micronutrient supplementation and nutrition education to improve healthy eating habits will significantly reduce poor birth outcomes such as low birth weights (LBW), still births, preterm deliveries, small or large for gestational age (SGA and LGA) and intrauterine growth restrictions in pregnant adolescents. This review provides to a large extent evidence to support the importance of adolescent nutrition and birth outcomes. There is the need to implement policies to improve adolescent nutrition through a multisectoral approach.

The influence of maternal health factors including multimorbidity on child oral health: A scoping review and evidence gap map protocol

Objective The objective of this scoping review is to map the extent and type of evidence in relation to the association between maternal health conditions, including multimorbidity and child oral health. Introduction Child oral health research has historically focussed on toothbrushing, diet and neglect of care, including not taking children to dental appointments. Newer theories are emerging that detail the many factors that can influence child oral health at child, family and community levels 1 . More recently, the association between maternal general health and child oral health has been explored, with preliminary evidence suggesting a link between shared environmental factors and direct maternal-to-child transfer of bacteria and diet/substance use during pregnancy causing childhood caries 2,3 . Inclusion criteria This review will include all published studies that describe the relationship between maternal health (including multimorbidity) and child oral health. There will be no limitation on the date of publication due to the limited number of studies available from the initial search of PubMed. The review will exclude case studies, abstracts, and grey literature. Literature must be in English language. Methods The following databases will be searched; CINAHL, Cochrane Library, Maternity and Infant Care, Medline via PubMed, Scopus, Web of Science. The search will include sources in English only and will be undertaken between April and July 2024. Studies to be included will be of any type of study design that describe a relationship between maternal health factors, including maternal oral health, and child oral health. Data extraction will be undertaken using tabulation of results by at least two independent reviewers. Narrative analysis of the evidence will be undertaken, and results will be presented in a narrative and tabular manner due to the heterogenous and limited evidence base found in the test search. This review has been registered prospectively on Open Science Framework, (https://doi.org/10.17605/OSF.IO/ECSWJ). The review will also inform an Evidence Gap Map (EGM) to illustrate the current evidence base regarding maternal health factors that influence child oral health.

The relationship between social determinants of health and girls’ age at menarche based on the world health organization model: path analysis

ObjectivesGiven the descending trend of menarche age and the effect of social determinants of health on menarche, the present study was conducted to examine the relationship model of social determinants of health with menarche age of girls. Materials and methodsThe present cross-sectional study enrolled 840 mothers and their 6-17 year-old daughters in the city of Kashan, Iran (2020). Questionnaires used included: demographic-family questionnaire for mothers and daughters, question about age at menarche, Perceived Social Support, Physical Activity, Socioeconomic Status, Spiritual Health, General Health Questionnaire, the quality of couple's relationship and the family communication pattern. The statistical analysis was performed in SPSS-16, and the relationship model was examined using path analysis method in LISREL-8.8. ResultsThe girls' menarche age was directly affected by sister's (b = 0.83) and mother's menarche age (b = 0.05), BMI (b = 0.01), physical activity (b = -0.06), conversation orientation (b = -0.002), socioeconomic status (b = -0.01) and maternal general health (b = 0.009). It was also indirectly affected by mother's menarche age, social support, socioeconomic status, and maternal spiritual health and parents relationships. ConclusionsThe results showed that the numerous factors affect the girls’ age at menarche directly and indirectly. Considering mutual interaction of factors revealed in the proposed model, it is recommended this model be used as an appropriate framework in research, design and implementation of programs relating to adolescent girls.

Breastfeeding mothers with COVID-19 infection: a case series

BackgroundThe first reports of the Chinese experience in the management of newborns of mothers with SARS-CoV 2 infection did not recommend mother-baby contact or breastfeeding. At present, the most important International Societies, such as WHO and UNICEF, promote breastfeeding and mother-baby contact as long as adequate measures to control COVID-19 infection are followed. In cases where maternal general health conditions impede direct breastfeeding or in cases of separation between mother and baby, health organizations encourage and support expressing milk and safely providing it to the infants.MethodsA series of 22 case studies of newborns to mothers with COVID-19 infection from March 14th to April 14th, 2020 was conducted. Mothers and newborns were followed for a median period of 1.8 consecutive months.ResultsOut of 22 mothers, 20 (90.9%) chose to breastfeed their babies during hospital admission. Timely initiation and skin to skin contact at delivery room was performed in 54.5 and 59.1%, respectively. Eighty two percent of newborns to mothers with COVID-19 were fed with breast milk after 1 month, decreasing to 77% at 1.8 months. Six of 22 (37.5%) mothers with COVID-19 required transitory complementary feeding until exclusive breastfeeding was achieved. During follow-up period, there were no major complications, and no neonates were infected during breastfeeding.ConclusionsOur experience shows that breastfeeding in newborns of mothers with COVID-19 is safe with the adequate infection control measures to avoid mother-baby contagion. Supplementing feeding with pasteurized donor human milk or infant formula may be effective, until exclusive breastfeeding is achieved.

Impact of Maternal Body Weight on the Growth of Offspring

Objective − Maternal general health and diet prior to and during pregnancy create conditions for intrauterine foetal development. This may influence long-term growth, development and health of the child. The aim of this study was to define the influence of maternal body weight (BW) on offspring growth in early childhood. Materials and Methods − 162 Slovenian mothers and their children were included in the study and subsequent analysis. We collected information on anthropometric measurements of mothers prior to and during pregnancy, and of their children (BW, length, head circumference (HC)) up to the age of three. To perform statistical analysis, the Pearson correlation test, linear regression and F-test were utilized. Results − A statistically significant association between the mother’s BW and newborn BW (P<0.01) and offspring BW up to three years of age (P< 0.05) was found. Linear regression showed a positive association between the mother’s BW and the newborn’s BW (P<0.01) and child's BW at one year of age (P<0.05). Additionally, a significant association between the mother's BW and children's HC at the age of 9 months (P<0.05) was determined and further confirmed by regression analysis. Conclusion − The study findings bring to light an important link between maternal BW and offspring growth in early childhood. Furthermore, the findings confirm the relevance of preventive strategies for improving the awareness of the importance of maternal health during pregnancy and the impact it can have on offspring growth.

Assessment of Maternal General Health and Feeding Pattern of their Infants: A Cross-sectional Study in Iranian Population

Background Various studies have been conducted so far regarding feeding infants exclusively with natural mother milk; various factors, which may influence feeding process, are occupation of mothers, sickness of infants or mother. This study aimed to assess the relationship between maternal general health and feeding pattern of infants. Materials and Methods This cross-sectional study was done in 2016. The society in this study was mothers with infants between 0-6 months referred to Imam Ali hospital (Sari, Iran). Using accessible sampling method, 250 mothers were selected. Then they were divided to two groups of dry-powder-milk (DPM, n = 125), and mother-milk (MM, n = 125). Subsequently, general health of mothers in both groups was assessed via General Health Questionnaire (GHQ). Then data were analyzed using the SPSS 16.0 (SPSS Inc., Chicago, IL, USA) by descriptive and inferential statistics tests. Results Mean age of mothers in dry-powder-milk (DPM) group, and mother-milk (MM) group was 28.53 ± 5.44 and 27.7 ± 5.15 years old, respectively. In overall results, general health were not significant difference between the two groups (p = 0.34), but only one dimension of general health (Social functioning) had significant differences between MM and DPM groups (p = 0.02). Conclusion Based on results, only one dimension of general health (Social functioning) had significant differences between two groups. So only social functioning had significant relation with feeding pattern of infants. Also, number of children had significant relationship with total score of GHQ. More studies are recommended to earn more detailed results.

Cumulative family risks across income levels predict deterioration of children's general health during childhood and adolescence.

Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children’s health. This study examined if multiple family risks might have cumulative effect on children and youth’s health across various levels of household income. The data in this study were drawn from the 2011–2012 U.S. National Survey of Children’s Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth’s poor health outcome (p < .001). When poverty levels were considered, however, the impact of CFRs on children and youth’s health was attenuated. The impact of CFRs was higher on children and youth from affluent families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children.

Maternal Depression and Mother-to-Infant Bonding: The Association of Delivery Mode, General Health and Stress Markers

Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a single baby at term were recruited with a total 435 mothers participating in the study. Outcome measures: Data were collected 6 months after delivery using General Health Questionnaire (GHQ-28), Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS) as well as socio-demographic and medical information at 6 months. Additionally, salivary cortisol and chromogranin levels were determined. Results: The proportion of breast-feeding mothers in the vaginal delivery group (51.4%) was significantly higher than that of the cesarean section group (24%). GHQ-28 scores were significantly related to EPDS scores and MIBS scores (P < 0.001)). EPDS scores were also associated with MIBS scores (P < 0.001)). However, there was no significant relationship between salivary stress marker levels and other questionnaire scores. MIBS scores of the vaginal delivery group (1.3 ± 1.7) were significantly better than those of the planned cesarean section group (2.1 ± 2.8). Multiple regression analysis revealed that maternal age and cesarean section were significantly associated with MIBS and EPDS scores (P < 0.01). Conclusion: Maternal general health is associated with maternal psychological health. These results suggest that the support of maternal health is important to maintain maternal psychological status and bonding to infants. Because EPDS scores were significantly worse in the planned cesarean section group (4.2 ± 3.3), careful management is needed of mothers who deliver by planned cesarean section.

Adolescent chronic pain and association to perinatal factors: linkage of Birth Registry data with the Young-HUNT Study.

The aim of this study was to examine the associations of birthweight, gestation and 5-min Apgar score with self-reported chronic nonspecific pain in a large, unselected adolescent population. The third population-based Nord-Trøndelag Health Study (HUNT) included 8200 adolescents aged 13-19 years, constituting 78.2% of adolescents in Nord-Trøndelag County. In the target age group, 13-18 years, data on pain frequency from 10 localizations were available from 7373 adolescents. Chronic nonspecific pain was defined as pain at least once a week during the last 3 months, not related to any known disease or injury. Chronic multisite pain was defined as chronic pain in at least three localizations, and chronic daily pain was defined as chronic pain almost every day. Perinatal data were retrieved from the Medical Birth Registry of Norway, and data were available for 7120 of the 7373 adolescents. Covariates included adolescent and maternal general health measures from the HUNT study. We found no consistent association between preterm birth and chronic pain and no clear association between birthweight and chronic pain complaints in adolescence. Post-term birth in boys and a low 5-min Apgar score in both sexes tended to increase the reporting of chronic pain in adolescence. Perinatal factors, and especially preterm birth and low birthweight, did not seem to have a major impact on pain complaints in adolescence.

Associations of childhood eczema severity: a US population-based study.

Little is known about the predictors of eczema severity in the US population. We sought to determine the distribution and associations of childhood eczema severity in the United States. We analyzed the data from the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children (range, 0-17 years). The prevalence of childhood eczema was 12.97% (95% confidence interval [95% CI], 12.42-13.53); 67.0% (95% CI, 64.8-69.2) had mild disease, 26.0% (95% CI, 23.9-28.1) had moderate disease, and 7.0% (95% CI, 5.8-8.3) had severe disease. There was significant statewide variation of the distribution of eczema severity (Rao-Scott χ, P = 0.004), with highest rates of severe disease in Mid-Atlantic and Midwestern states. In univariate models, eczema severity was increased with older age, African American and Hispanic race/ethnicity, lower household income, oldest child in the family, home with a single mother, lower paternal/maternal education level, maternal general health, maternal/paternal emotional health, dilapidated housing, and garbage on the streets. In multivariate survey logistic regression models using stepwise and backward selection, moderate-to-severe eczema was associated with older age, lower household income, and fair or poor maternal health but inversely associated with birthplace outside the United States. These data indicate that environmental and/or lifestyle factors play an important role in eczema severity.

Maternal general health and children's cognitive development and behaviour in the early years: findings from the Millennium Cohort Study

Mothers often experience physical and psychological difficulties during the post-natal period and these may continue through the early years of raising children and have negative effects on engagement and caregiving. Pathways between maternal depression, parental engagement and caregiving and children's subsequent development have been described in longitudinal studies; yet, less is known about how other aspects of maternal health may influence children's development. A longitudinal analysis within the Millennium Cohort Study was conducted including 7906 families from England. Maternal general health and psychological well-being were assessed when their children were 9 months and 3 years old, socio-demographic characteristics were assessed at 9 months, and engagement and caregiving were assessed at 3 years. These were examined as predictors of children's learning and development and behaviour at age 5. There are clear associations between maternal general health and children's development with regard to both learning and development and behaviour. These effects are reduced if psychological distress is taken into account; yet, maternal general health maintains importance as a predictor for children's subsequent development. There is evidence of an association via engagement and caregiving which links maternal health to children's development and evidence of the influence of underlying socio-demographic disadvantage. General maternal health as well as psychological well-being during the early years of raising children may be influential for children's development. This study suggests the need for a broader recognition of maternal health as well as psychological well-being as a foundation for family well-being, and speaks to support for mothers in maintaining engagement and caregiving for their children during periods of ill health.

Factors influencing parenting in early childhood: a prospective longitudinal study focusing on change

Parenting influences child outcomes but does not occur in a vacuum. It is influenced by socio-economic resources, parental health, and child characteristics. Our aim was to investigate the relative importance of these influences by exploring the relationship between changing parental health and socio-economic circumstances and changes in parenting. Data collected from the Avon Longitudinal Study of Parents and Children were used to develop an eight-item parenting measure at 8 and 33 months. The measure covered warmth, support, rejection, and control and proved valid and reliable. Regression analysis examined changes in financial circumstance, housing tenure, marital status, social support, maternal health and depression, and their influence on parenting score. The final model controlled for maternal age, education, and baseline depression. Most mothers reported warm, supportive parenting at both times. Maternal depression was the only variable for which both positive and negative change was associated with changes in parenting score. Less depression was associated with better parenting scores and more depression with worse parenting scores. Improvements in social support and maternal general health were both associated with improved parenting scores, but for neither of these variables was deterioration associated with deterioration in parenting scores. Worsening financial circumstances predicted deterioration in parenting score, but improvements were not predictive of improvements in parenting. Programmes aiming to improve parental health and social support are likely to return greater dividends with regard to improving parenting than programmes that aim to reduce family poverty.

The Correlation Between Postpartum Depression and Health Status

To investigate a purported correlation between postpartum depression and self-rated maternal general health status in a sample of mothers in Southern Brazil. As part of this process, the Personal Health Scale (PHS), a self-rated health status measure, was tested for the first time among postpartum women. Research volunteers completed the Structured Clinical Interview for DSM-IV Disorders (SCID), the 12-item General Health Questionnaire (GHQ), the PHS, the Postpartum Depression Screening Scale (PDSS), and the Edinburgh Postnatal Depression Scale (EPDS). Correlation coefficients were computed among the scores of the health status questionnaires and the postnatal depression scales. Bivariate linear regression analyses were conducted to evaluate the prediction of scores of postnatal depression scales having the scores of health status questionnaires as predictors. Significant correlations among both health status questionnaires and both postnatal screening tools attest to a significant interconnection between the expression of depressive symptoms and maternal health status in the postpartum period. The health status measures predicted the scores of postpartum depression scales. This study demonstrates that both general health questionnaires and postpartum depressive rating scales are useful tools for detecting depressive phenomena in postpartum women. The association between self-rated health measures and postpartum depression may be even more significant in the context of socioeconomic deprivation.

Adverse Associations of Infant and Child Sleep Problems and Parent Health: An Australian Population Study

Infant sleep problems are strongly associated with poorer maternal mental health. It is not known whether they are also associated with poorer paternal mental health, nor whether sleep problems in older children are associated with maternal or paternal mental health. We aimed to examine relationships between child sleep problems and maternal and paternal mental health and general well-being in each of the infant and preschool-aged groups. Participants of this cross-sectional survey included families of infants (n = 5107) and preschool-aged children (n = 4983) participating in the first wave of the nationally representative Longitudinal Study of Australian Children, surveyed March through November 2004. The primary outcomes were mother and father serious psychological distress (measured by the Kessler-6) and general health (parent report of general health taken from the 12-item Short Form Health Survey and dichotomized into poor versus good health). A primary caregiver's report of the child's sleep problem was dichotomized into moderate/severe versus none/mild. The prevalence of severe psychological distress ranged from 3% to 5%, and prevalence of poor general health ranged from 8% to 11%. Moderate to severe sleep problems affected 17% of infants and 14% of preschool-aged children. Infant sleep problems were associated with poor general health in mothers and with poor general health in fathers. Preschool sleep problems were associated with poor maternal general health. In mothers with no past history of depression, infant sleep problems had a greater effect on severe psychological distress compared with mothers with a past history of depression. Sleep problems are common in infants and preschool-aged children. Infant sleep problems, in particular, are associated with poorer health in both parents, especially the mental health of mothers with no past history of depression.