Maternal Income Research Articles

MATERNAL SOCIOECONOMIC STATUS AND CHILD HEALTH IN NIGERIA: EVIDENCE FROM EKITI STATE.

We examine the impact of the socio-economic status of mothers on child health in Nigeria regarding Ekiti State. The research employed a cross-sectional research design method where data were collected randomly in the selected unit of population. The sample size was determined following the sample size determination proposed by Taro Yamane to be 400 mothers between the ages 18-56 years, with a sampling error of 5 percent and the confidence level assumed to be 95%. Data were collected using structured questionnaires with a ratio of 3:2 i.e, 60% to relative urban and 40% to relative rural areas. The study adopts the logistic regression technique. The findings show that maternal occupation and income raise the odds of under-five children contracting malaria, while raise in maternal education of a child, in both conventional and child/health education are less likely to experience malaria. The study recommends that mothers are encouraged to be more committed and/or active in participating in childcare activities to reduce the vulnerability of the children to the malaria parasite.

Child undernutrition and associated factors among children 6-23 months old in largely food insecure areas of rural Ethiopia.

Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother-child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of <0⋅05 in multivariate analysis were used to detect statistical significance at a 95 % confidence level. About 67 % of households are food insecure. The prevalence of stunting wasting and underweight were 42⋅7, 9⋅9 and 27⋅7 %, respectively. Female gender, higher age of the child (12-23 months v. 6-11 months), living in a household with five or more siblings, not getting therapeutic zinc supplement at least once, inadequate diet diversity, lack of growth monitoring service, and maternal own income increases the likelihood of child undernutrition. It can be concluded that child undernutrition is a severe public health problem in the study area. Improving primary healthcare services related to zinc supplementation, growth monitoring and promotion, and improving infant and child feeding practices can be considered as a strategy to address the problem.

Factors Associated with the Nutritional Status of Toddlers at the Limo Community Health Center, Depok City, Indonesia

Undernutrition in urban areas remains a serious public health problem in Indonesia. The study aimed to find out what factors were related to the nutritional status of children under five in the working area of the Limo Community Health Center, Limo District. Depok City, Indonesia in 2019. This research was conducted in June-July 2019 using a cross-sectional study design with a sample of 118 mothers who have toddlers aged 6-59 months in the Limo Health Center work area in 2019. The sampling technique used simple random sampling. The analysis was performed using chi-square (α = 0.05). Undernutrition is defined as the condition of children under five which is determined based on the anthropometric index measurement results of body weight for age with a Z- score of -2 SD to ≤ -3 SD, while good nutrition is at a Z-score of -2 SD to 2 SD. As a result, the prevalence of undernutrition was 16.1%. As much as 50% of the respondents had high school education and mothers with low education were 32.2%. The results showed a prevalence of working mothers (13.6%), family income &lt; Rp. 4,600,000 (52.5%), mothers with low knowledge (25.4%), male children (53.4%), poor parenting (3.4%), and mothers who did not use health services properly (3.4%). There was a significant relationship between maternal education (p = 0.004; OR: 4,813; 95% CI: 1,711-13,537), family income (p = 0.006; OR: 6.145; 95% CI: 1.68-22.43), and maternal knowledge (p = 0.007; OR: 4.389; 95% CI: 1.57-12.23) with the nutritional status of children under five in the working area of the Limo Community Health Center. The suggestion is that the Limo Community Health Center make a program to increase the knowledge capacity of mothers regarding the nutrition of their children.

The association between miscarriage and fecundability: the Norwegian Mother, Father and Child Cohort Study.

STUDY QUESTIONIs fecundability associated with miscarriage history and future miscarriage risk?SUMMARY ANSWERPrior miscarriage was associated with lower fecundability, and participants with a history of subfertility (time-to-pregnancy (TTP) ≥12 months) were at a higher risk of subsequent miscarriage.WHAT IS KNOWN ALREADYAlthough miscarriage and low fecundability share common risk factors, prior studies have reported both lower and higher fecundability after miscarriage.STUDY DESIGN, SIZE, DURATIONIn this study, we examined two related associations: one, between miscarriage history and subsequent fecundability and, two, between fecundability and miscarriage risk in the subsequent pregnancy. The study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). In addition, the outcome of the pregnancy after the MoBa index pregnancy was obtained by linking information from three national health registries: the Medical Birth Registry of Norway, the Norwegian Patient Registry and the general practice database.PARTICIPANTS/MATERIALS, SETTING, METHODSWe examined the association between number of prior miscarriages and fecundability in 48 537 naturally conceived, planned pregnancies in participants with at least one prior pregnancy. We estimated fecundability ratios (FRs) and 95% CIs using proportional probability regression. We further estimated the relative risk (RR) of miscarriage in the subsequent pregnancy as a function of TTP in the MoBa index pregnancy for 7889 pregnancies using log-binomial regression. Multivariable analyses adjusted for maternal age, pre-pregnancy maternal BMI, smoking status, cycle regularity, income level and highest completed or ongoing education.MAIN RESULTS AND THE ROLE OF CHANCEFecundability decreased as the number of prior miscarriages increased. The adjusted FRs among women with one, two and three or more prior miscarriages were 0.83 (95% CI: 0.80–0.85), 0.79 (95% CI: 0.74–0.83) and 0.74 (95% CI: 0.67–0.82), respectively, compared with women with no prior miscarriages. Compared to women with a TTP of <3 months, the adjusted RR of miscarriage in the subsequent pregnancy was 1.16 (0.99–1.35) with TTP of 3–6 months, 1.18 (0.93–1.49) with TTP of 7–11 months and 1.43 (1.13–1.81) with TTP of 12 or more months.LIMITATIONS, REASONS FOR CAUTIONInformation on TTP and prior miscarriages was obtained retrospectively, and TTP was self-reported. MoBa is a pregnancy cohort, and findings may not be generalizable to all women. We were unable to examine the effect of changing partners between pregnancies, as well as other paternal factors such as seminal parameters. We also did not know what proportion of our participants had changed partners between their prior pregnancies and the index pregnancy. Furthermore, it is likely that many early miscarriages are not recognized.WIDER IMPLICATIONS OF THE FINDINGSThe association between miscarriage and fecundability may reflect a contribution of occult pregnancy losses to TTP, as well as shared underlying causes for reduced fecundability and miscarriage.STUDY FUNDING/COMPETING INTEREST(S)The study was funded by the Research Council of Norway through its Medical Student Research Program funding scheme (project number 271555/F20), its Centres of Excellence funding scheme (project number 262700) and through the project ‘Women's fertility – an essential component of health and well-being’ (project number 320656). M.C.M. has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement number 947684). A.J.W. is supported by the Intramural Program of the National Institute of Environmental Health Sciences at the National Institutes of Health, USA. The authors report no competing interests.TRIAL REGISTRATION NUMBERN/A.

Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study

BackgroundEarly uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study.MethodsTotal maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years.ResultsChildren of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%).ConclusionsLower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course.

Nitrate in Danish household tap water and the risk of small-for-gestational-age, 1991-2015

BACKGROUND AND AIM: Findings from studies examining the effects of prenatal exposure to nitrate from drinking water on fetal growth have been inconsistent, small, and mostly ecologic in nature. The aim of this study was to assess maternal exposure to nitrate (NO₃⁻) in drinking water and small-for-gestational-age in a large population-based cohort. METHODS: Exposure estimates from each maternal address during pregnancy were obtained from a national public and private water monitoring database. We linked these individual household nitrate concentrations with individual-level birth registry data to create a cohort of 1,078,892 singleton live births in Denmark to Danish-born parents during 1991–2015. Exposures were modeled as log-transformed continuous estimates and categorically. Small-for-gestational-age was defined as the lightest 10% of infants at birth per sex and gestational week. Multivariable logistic regression with generalized estimating equations was used to assess associations and account for the non-independence of siblings. National register-based data were used to adjust for sex, birth year, birth order, and maternal age, smoking, education, income, and employment status at the individual level. RESULTS:In this cohort, the median nitrate concentration was 1.9 mg/L NO₃⁻. An increased risk of small-for-gestational-age was observed when comparing half the European Union standard (25 mg/L NO₃⁻) to 1 mg/L NO₃⁻ [OR: 1.03 (95% CI: 1.01, 1.05)] and in categorical analyses, except for the highest category (25 mg/L NO₃⁻) compared to the referent (2 mg/L NO₃⁻), possibly due to small numbers. CONCLUSIONS:In this nationwide study spanning 25 years, we found that nitrate in maternal household tap water during pregnancy was associated with an increased risk of her child being born small-for-gestational-age. While the increased risk may be small at an individual level, given the widespread presence of nitrate in drinking water it is important on a global scale. When evaluating nitrate regulations, policymakers should focus on health impacts at levels below current standards. KEYWORDS: Big data, Birth outcomes, Children's environmental health, Environmental epidemiology, International collaboration, Water quality

Prenatal exposure to nitrate from household drinking water and the risk of preterm birth: A nationwide study from Denmark, 2011-2015

BACKGROUND AND AIM: Only two studies of prenatal exposure to nitrate from drinking water and the risk of preterm birth have been conducted, both with ecologic exposures and from the US. We aimed to examine this relationship utilizing individual-level exposure estimates in Denmark. METHODS: Nationwide register-based health data from singleton live births during 1991–2015 born to Danish-born parents were linked to national water monitoring and administrative data, including each maternal residence during pregnancy. The association between individual-level prenatal nitrate (NO₃⁻) exposure from household drinking water and the odds of preterm birth (37 weeks gestation) was evaluated using logistic regression with generalized estimating equations to account for sibling clusters. Models were adjusted for sex, birth year, birth order, urbanicity, and maternal age, smoking, education, income, and employment status at the individual level. RESULTS:Using a complete case analysis, 1,009,189 births were included in main models, including 3.6% of households with nitrate levels 25 mg/L NO₃⁻ (half the European Union standard) and 5.1% of births being preterm. The median exposure in the cohort was 1.9 (IQR: 1.0–3.4) mg/L NO₃⁻. An increased risk of preterm birth was seen across categories of exposure ({p}0.001) with an odds ratio in the uppermost category (25 mg/L NO₃⁻) of 1.05 (95% CI: 1.00, 1.10) compared to the referent (2 mg/L NO₃⁻). Continuous models also demonstrated an increased risk of preterm birth per 10 mg/L NO₃⁻ increase [OR: 1.01 (95% CI: 1.00, 1.03)]. CONCLUSIONS:We observed an increased risk of preterm birth as nitrate concentrations in maternal household drinking water increased. This estimated risk was of a similar magnitude as the two previous studies from the US. Our findings add to a body of evidence of the physical harm from nitrate in drinking water, even at concentrations below current regulatory levels. Policymakers may consider lowering maximum contaminant levels to protect public health. KEYWORDS: Big data, Birth outcomes, Children's environmental health, Environmental epidemiology, International collaboration, Water quality

Maternal psychological distress, education, household income, and congenital heart defects: a prospective cohort study from the Japan environment and children\u2019s study

BackgroundThe influence of maternal psychological distress on infant congenital heart defects (CHDs) has not been thoroughly investigated. Furthermore, there have been no reports on the combined effect of maternal psychological distress and socioeconomic status on infant CHDs. This study aimed to examine whether maternal psychological distress, socioeconomic status, and their combinations were associated with CHD.MethodsWe conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women between 2011 and 2014. Maternal psychological distress was evaluated using the Kessler Psychological Distress Scale in the first trimester, while maternal education and household income were evaluated in the second and third trimesters. The outcome of infant CHD was determined using the medical records at 1 month of age and/or at birth. Crude- and confounder-adjusted logistic regression analyses were performed to evaluate the association between maternal psychological distress and education and household income on infant CHD.ResultsA total of 93,643 pairs of mothers and infants were analyzed, with 1.1% of infants having CHDs. Maternal psychological distress had a significantly higher odds ratio in the crude analysis but not in the adjusted analysis, while maternal education and household income were statistically insignificant. In the analysis of the combination variable of lowest education and psychological distress, the P for trend was statistically significant in the crude and multivariate model excluding anti-depressant medication, but the significance disappeared in the full model (P = 0.050).ConclusionsThe combination of maternal psychological distress and lower education may be a possible indicator of infant CHD.

Urban-rural differences in the prevalence of female pattern hair loss among secondary school girls: A cross-sectional study.

Female pattern hair loss (FPHL) is a common condition that is influenced by many external and internal factors. We aimed to identify the prevalence of FPHL among secondary school girls and identify possible associated factors. FPHL among 3405 adolescent females was identified using detailed history, physical examination, and dermoscopy in this cross-sectional study. Among the 3405 included students, 2430 (71.4%) had no FPHL and 975 (28.6%) were diagnosed with FPHL (p=0.001). The mean age of girls with FPHL was 16.43±1.10 and ranged between 15 and 18years. Among those with FPHL, 427 (43.8%) attended urban schools while 548 (56.2%) attended rural schools. No significant differences regarding paternal and maternal education, family income, or parental degree of education were observed among those with FPHL and those without (p=0.230; p=0.063; p=0.276, respectively). FPHL had an overall prevalence of 28.6% among secondary school girls with a significant predominance in rural over urban areas and with a significantly associated family history. Irregular menses, history of thyroid disease, and hirsutism were significant predictors for FPHL.

Breastfeeding Practice and Association between Characteristics and Experiences of Mothers Living in Bangkok.

Although the benefits of breastfeeding are widely recognized, only 14% of mothers in Thailand exclusively breastfed their children during the first six months of their lives in 2019, which dropped from 23% in 2016. This study aimed to assess the prevalence of exclusive breastfeeding (EBF) up to six months, current breastfeeding patterns, and key determinants that influence six-month EBF among mothers residing in Bangkok, Thailand. A cross-sectional study was conducted using a self-administered questionnaire survey. In total, 676 healthy mothers living in Bangkok, whose most recent child was between 6 and 18 months old, were recruited. Descriptive statistics, univariable analysis by Chi-square test, and multivariable logistic regression were performed to assess the association between six-month EBF and maternal characteristics and experiences of using maternal health services. The prevalence of six-month EBF of infants in Bangkok was 41%. The key determinants that influenced six-month EBF included: maternal age of more than 30 years; higher education level; higher maternal income; multi-parity; exposure to breastfeeding advice during pregnancy; intention to breastfeed for a long duration (≥6 months) during pregnancy; experience of six-month EBF in the previous child. This study draws health professionals’ and policy makers’ attention to further promote breastfeeding in particular types of mothers.

An immunogenomic phenotype predicting behavioral treatment response: Toward precision psychiatry for mothers and children with trauma exposure

Inflammatory pathways predict antidepressant treatment non-response among individuals with major depression; yet, this phenomenon may have broader transdiagnostic and transtherapeutic relevance. Among trauma-exposed mothers (Mage = 32 years) and their young children (Mage = 4 years), we tested whether genomic and proteomic biomarkers of pro-inflammatory imbalance prospectively predicted treatment response (PTSD and depression) to an empirically-supported behavioral treatment. Forty-three mother–child dyads without chronic disease completed Child Parent Psychotherapy (CPP) for roughly 9 months. Maternal blood was drawn pre-treatment, CD14 + monocytes isolated, gene expression derived from RNA sequencing (n = 34; Illumina HiSeq 4000;TruSeqcDNA library), and serum assayed (n = 43) for C-Reactive Protein (CRP) and interleukin-1ß (IL-1ß). Symptoms of PTSD and depression decreased significantly from pre- to post-treatment for both mothers and children (all p’s < 0.01). Nonetheless, a higher pre-treatment maternal pro-inflammatory imbalance of M1-like versus M2-like macrophage-associated RNA expression (M1/M2) (ß = 0.476, p = .004) and IL-1ß (ß=0.333, p = .029), but not CRP, predicted lesser improvements in maternal PTSD symptoms, unadjusted and adjusting for maternal age, BMI, ethnicity, antidepressant use, income, education, and US birth. Only higher pre-treatment M1/M2 predicted a clinically-relevant threshold of PTSD non-response among mothers (OR = 3.364, p = .015; ROC-AUC = 0.78). Additionally, higher M1/M2 predicted lesser decline in maternal depressive symptoms (ß = 0.556, p = .001), though not independent of PTSD symptoms. For child outcomes, higher maternal IL-1ß significantly predicted poorer PTSD and depression symptom trajectories (ß’s = 0.318-0.429, p’s < 0.01), while M1/M2 and CRP were marginally associated with poorer PTSD symptom improvement (ß’s = 0.295–0.333, p’s < 0.056). Pre-treatment pro-inflammatory imbalance prospectively predicts poorer transdiagnostic symptom response to an empirically-supported behavioral treatment for trauma-exposed women and their young children.

IMPACT OF ULTRASOUND AND SOCIODEMOGRAPHIC VARIABLES ON MATERNAL FOETAL ATTACHMENT IN TARABA STATE, NIGERIA

Background: Maternal foetal attachment is manifested in behaviours that demonstrate care and commitment to the foetus. Ultrasound decreases maternal anxiety and confers psychological benefits following a reassuring sonogram. Maternal-foetal attachment is affected by many socio-demographic factors which include maternal age, occupation, educational level, race, marriage duration, ethnicity, Religion, income status, pregnancy planning, and identification of the foetal gender Aim: This study was aimed at assessing the effect of ultrasound and sociodemographic factors on maternal foetal attachment during pregnancy. Method: A prospective study was conducted from November 2019 to March 2020. A convenient sampling method was employed and included 404 pregnant women aged 18-45 years old in their 2nd and 3rd trimesters. The data were collected using a maternal foetal attachment scale questionnaire. Descriptive and inferential statistics were carried out at a p-value &lt; 0.05. Result: The score of the maternal foetal attachment scale was greater with post ultrasound than the pre ultrasound. There was a statistically significant difference between the pre and post ultrasound maternal foetal attachment scale (p=0.000). A statistically significant difference was observed in the maternal foetal attachment across the different ethnic groups (p=0.000), planned and unplanned pregnancy (p=0.000). Conclusion: This study revealed that ultrasound scan has an influence on maternal foetal attachment, planned pregnancy. Hausa, Bandawa and Jenjo were found to be more attached to their foetuses.

Power and Efficacy of Maternal Voice in Neonatal Intensive Care Units: Implicit Bias and Family-Centered Care.

Implicit bias can lead medical professionals in Neonatal Intensive Care Units (NICUs) to disregard mothers who are Black and economically disadvantaged as they advocate for their infants' health. Disregard can weaken underlying communication principles within the Family-Centered Care (FCC) model of pediatric health in NICUs and increase maternal distress. This study is the first to address communication disregard by examining mothers' perceived power and efficacy of voice with NICU doctors and nurses. We hypothesized that mothers who are Black and economically disadvantaged would report lower efficacy of voice and higher levels of distress as compared to White mothers with higher income. During pre-assessment within a small clinical trial of a parenting intervention, 33 racially and economically diverse mothers, from three Midwest NICUs serving the urban poor, responded to a 14-item measure of maternal power and efficacy of voice and measures of somatization, depression, anxiety and eating/sleeping disorders. Nonparametric examinations assessed the relation of power and efficacy of voice to maternal race, income, and distress. In contrast to White, higher-income mothers, Black, economically disadvantaged mothers reported lower perceived efficacy of voice with doctors (U = 74.5, d = 0.65) and nurses (U = 74.0; d = .0.66). These mothers with lower perceived efficacy with doctors and nurses, reported higher levels of somatization (U = 16.5, d = 1.14; U = 13.5, d = 1.38, respectively) and eating disorders (U = 14.0, d = 1.29; U = 12.0, d = 1.48, respectively). Study results are discussed within the framework of implicit bias in FCC in the NICU, expanding our understanding of effective communicationwith economically stressed,Black mothers.

Socio-economic inequalities in dental pain in children: A birth cohort study.

To describe socio-economic inequalities in dental pain and dental caries in 5 and 12-year-old children enrolled in a birth cohort. This prospective study was carried out with children enrolled in a birth cohort in Pelotas, Brazil. The main outcome was history of dental pain in the last six months, collected at 5 and 12years of age. Dental caries was evaluated as a secondary outcome. Inequalities dimensions were investigated using maternal education and family income. The inequalities indicators used were the slope index of inequality (SII) and the concentration index (CIX). Some 1,114 and 990 children were included in the analyses at the 5- and 12-year follow-ups, respectively. The prevalence of dental pain was 16.5% (95% CI 14.4-18.8) at 5years and 31.6% (95% CI 28.7-34.6) at 12years. Regarding SII, the difference in the prevalence of dental pain was 14 and 11 percentage points at 5 and 12years, respectively, when comparing the less to the more maternal schooled strata. Relative inequalities (CIX) were found for dental pain only at age 12, considering family income (-5.8 CI95% -11.0; -0.6). Absolute socio-economic inequalities were also observed for dental caries in both ages. Dental pain in the last six months and dental caries was unequally distributed. Economically disadvantaged groups had the highest prevalence of dental pain and dental caries in both dentitions. Actions to tackle socio-economic inequalities must be designed throughout life.

The relationship between breastfeeding and maternal education and family income

Aim. To assess the relationship between breastfeeding and maternal education and family income in Samara.&#x0D; Methods. A survey was conducted among 174 mothers in the children's outpatient clinic, in which their children were assigned at the place of residence. Information on breastfeeding and its duration, mother's education, and family income were obtained by questionnaire and copying data from outpatient records. Pearson's chi-square, MannWhitney U test and logistic regression were used in the statistical processing of the data.&#x0D; Results. There was a positive association of maternal education (2=11.25; p=0.024) and income (2=11.5; p=0.022) with breastfeeding practices. Higher education, compared with specialized secondary or secondary education, increased the likelihood of breastfeeding for more than 6 months with an odds ratio of 2.6 (95% confidence interval 1.185.73; p=0.018). The median (and its Q1Q3 quartiles) breastfeeding duration was 4.0 months (Q1Q3 2.014.0 months) for mothers with secondary or specialized secondary education and 12.0 months (Q1Q3 4.018.0 months; p=0.012) for mothers with higher education. It was found that 67.7% of women with incomes above the subsistence level per family member ($150) breastfed for more than 7 months and only 43.9% of women with incomes below the subsistence level (p=0.011). The likelihood of breastfeeding for more than 6 months in household income above one minimum wage per family member compared with household income below increases with an odds ratio of 2.18 (95% confidence interval 1.034.60; p=0.041). There was no relationship between lactation cessation and maternal education or family income.&#x0D; Conclusion. There is a positive relationship between mother's education and family income and the practice of breastfeeding.

ANALISIS ASUPAN ZAT GIZI BATITA BERDASARKAN TINGKAT PENDIDIKAN, STATUS BEKERJA DAN PENGETAHUAN IBU

Background: Acute malnutrition could increase mortality and morbidity indirectly in infants and toddlers. The family socio-economic characteristics including the maternal education, nutritional knowledge, and family income, are related to the incidence of stunting.Objective: To determine the relationship between maternal education, working status and knowledge on dietary intake among toddlers under 3 years old.Methods: A correlative analytic study with cross-sectional design. The populations were mothers with toddlers under 3 years old. Sample size were 70 mothers which obtained with the cluster random sampling technique. Data collection were used questionnaire and calculated with 2005 Nutria survey and 14 levels.Results: There were no significant relationship between education level and working status on dietary intake of children under 3 years old (OR: 0,88; ᵖ-value: 0,855; CI: 0,136-4,136) and (OR: 1,29 ᵖ-value: 0,674; CI: 0.298-4.987). However, there were significant relationship between maternal knowledge and dietary intake of children under 3 years, especially related with energy and protein intake (OR: 2,14 ᵖ-value: 0,043; CI: 1,043-17,045). Conclusions: Maternal knowledge level are related to dietary intake among children under 3 years old, relared with energy and protein intake.

Individual and neighbourhood socioeconomic measures and the risk of non-central nervous system solid tumours in children: A nationwide register-based case-control study in Denmark

BackgroundThe aetiology for most solid tumours in childhood is largely unknown. The lack of evidence concerns also the relationship between socioeconomic position (SEP) and risk of childhood solid tumours other than in the central nervous system (CNS). We sought to access the association between individual and neighbourhood SEP measures and risk of childhood non-CNS solid tumours in Denmark and to evaluate whether associations varied by measure of SEP, time point of SEP assessment (during pregnancy versus before diagnosis) and tumour type. MethodsWe conducted a nationwide case-control study based on Danish registry data. We identified all children born in 1980–2013 and diagnosed with a non-CNS solid tumour at ages 0–19 years (N = 1961) from the Danish Cancer Registry and sampled four individually matched controls per case using the Population Registry. We fitted conditional logistic regression models to estimate associations with register-based individual-level and neighbourhood-level SEP measures. ResultsWe observed a tendency of increased odd ratios (OR) in association with medium and high maternal income for most tumour types (e.g. OR for the highest income quintile and malignant bone tumours = 2.11; 95 % CI: 1.01, 4.38) and for parental education in association with higher education for some tumour types. For malignant epithelial neoplasms, higher parental education and income level were overall associated with an increased risk, e.g. OR = 1.63 (95 % CI: 1.00, 2.65) for the fourth group of maternal income during pregnancy. We found no risk pattern for neighbourhood SEP. ConclusionThis large register-study with minimal risk of bias found a tendency of slightly to moderately increased risks for most childhood non-CNS solid tumours in association with higher maternal income and parental education. Future research examining the underlying mechanisms of these socioeconomic differences in non-CNS solid tumours as well as other childhood cancer types are warranted.

Early childhood caries: Are maternal psychosocial factors, decision-making ability, and caries status risk indicators for children in a sub-urban Nigerian population?

ObjectiveEarly childhood caries (ECC) is caries in children below the age of 72 months. The aim of the study was to determine the association of maternal psychosocial factors (general anxiety, dental anxiety, sense of coherence, parenting stress, fatalism, social support, depressive symptoms, and executive dysfunction), decision-making abilities, education, income and caries status with the prevalence and severity of ECC among children resident in Ile-Ife, Nigeria.MethodsA dataset of 1549 mother–child (6–71-months-old) dyads collected through examinations and a household survey, using validated psychometric tools to measure the psychosocial factors, were analyzed. The DMFT for the mothers and the dmft for the child were determined. The association between maternal psychosocial factors, education, income, and decision-making ability, the prevalence of maternal caries, and the prevalence of ECC was determined using logistic regression analysis.ResultsThe prevalence of maternal caries was 3.3%, and the mean (standard deviation-SD) DMFT was 0.10 (0.76). The ECC prevalence was 4.3%, and the mean (SD) dmft was 0.13 (0.92). There was no significant difference between the prevalence and severity of maternal caries and ECC by maternal age, education, income, or decision-making abilities. There was also no significant difference in maternal caries, ECC prevalence and ECC severity by maternal psychosocial factors. The only significant association was between the prevalence of caries in the mother and children: children whose mothers had caries were over six times more likely to have ECC than were children with mothers who had no caries (AOR: 6.67; 95% CI 3.23–13.79; p < 0.001).ConclusionThe significant association between ECC and maternal caries prevalence suggests that prenatal oral health care for mothers may reduce the risk for ECC.

187 Mental health clusters during COVID-19 pandemic are associated with multiple dimensions of sleep in a sample of pregnant women

IntroductionSleep and mental health have a bidirectional relationship. During pregnancy, poor sleep health, depression and stress are common and have been associated with poor maternal and fetal outcomes. The COVID-19 pandemic has introduced additional physical and psychological risk factors, due to high mortality rate, and economic and social repercussions. This study examines whether prenatal maternal mental health clusters are associated with multiple dimensions of sleep during pregnancy in the context of the COVID-19 pandemic.MethodsFrom June-December 2020, participants were recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) Cohort at Columbia University (N=188; at recruitment gestational age: 32.2±8.2 weeks; age: 32±6.75 years; N=74 Hispanic, N=65 White non-Hispanic, N=27 Black/African American, N=22 other). Survey data on maternal depression (PHQ-9), perceived stress (PSS), Covid-related stress, and sleep health (PSQI) were collected. Using hierarchical clustering, we created maternal mental health clusters (MMHC). Regressions analyses were implemented to estimate the associations between multiple dimensions of sleep based on MMHC.Results\\We derived three MMHC: Low-risk (no depression, no Covid-stress, low-moderate perceived stress), Covid-stress (no depression, moderate Covid-stress, low-moderate perceived stress) and high-risk (moderate depression, moderate Covid-stress, moderate to high perceived stress). Maternal age, gestational age, income, and race were not significantly different across clusters. The Covid-stress cluster compared to the low-risk cluster reported worse subjective sleep quality (ß=0.34±0.11, p=0.0025), longer sleep latency (ß=0.44±0.13,p<0.000), more sleep disturbances (ß=0.67±0.18, p=0.004) and an overall higher PSQI score (ß=0.32±0.13,p=0.017). Compared to the low-risk group, the high-risk group reported worse subjective sleep quality (ß=0.96±0.3,p<0.000), longer sleep latency (ß=0.79±0.13,p<0.000), shorter sleep duration (ß=0.67±0.18,p=0.0003), lower sleep efficiency (ß=0.67±0.25,p=0.008), more sleep disturbances (ß=0.59±0.10, p<0.000), higher daytime dysfunction (ß=0.85±0.10, p=0.000) and an overall higher PISQI score (ß=1.15±0.16, p<0.000).ConclusionOur results indicate that the COVID-19 pandemic has affected mental health profiles during pregnancy, with evidence of a high-risk cluster presenting Covid-stress and depressive symptoms and a Covid-stress cluster presenting Covid-stress without depressive symptoms in a multi-ethnic sample of pregnant women. Both were associated with poorer sleep health outcomes compared to the low-risk cluster. These results have important implications for screening and treatment for the sleep health and obstetric communities during these unprecedented times.Support (if any):

Determinants of Incomplete Vaccination Among Children Aged 12 to 23 Months in Gindhir District, Southeastern Ethiopia: Unmatched Case-Control Study.

BackgroundIncomplete vaccination can put children at greater risk of acquiring vaccine-preventable diseases. In Ethiopia, vaccination coverage against vaccine-preventable diseases is still a significant and persistent public health challenge. Thus, the aim of this study was to identify the determinants of incomplete childhood vaccination among children aged 12–23 months in Gindhir District, Southeast Ethiopia.MethodsA community-based unmatched case–control design was employed among children aged 12–23 months from 1 to 28 February 2020. A total of 254 cases and 508 controls were included using the stratified random sampling technique. Cases included children aged 12–23 months who missed at least one dose of the routine vaccination, and controls were the children with complete vaccination with all required doses. Binary logistic regression analyses were used to identify the independent factors for children’s incomplete vaccination status.ResultsOf all assessed determinants, maternal knowledge about vaccination (AOR=0.50, 95% CI: 0.31, 0.80), educational status (AOR=2.61, 95% CI: 1.19, 5.67), average monthly income (AOR=0.33, 95% CI: 0.15, 0.77), model family (AOR = 2.50, 95% CI: 1.51, 4.14), taking TT vaccine (AOR= 0.45 95% CI: 0.29, 0.78), number of under five children (AOR= 4.90 95% CI: 1.72, 13.93) and birth order (AOR= 6.33, 95% CI: 1.89, 14.87) were found to have statistically significant association with childhood incomplete vaccination.ConclusionIn this study, the mother’s education, model family, birth order, average monthly income, and knowledge were some of the independent determinants of incomplete childhood vaccination. Improving maternal knowledge, income, and educational status should be the expectable measure to reduce incomplete vaccination.