Maternal Smoking Habits Research Articles

Children`s dietary patterns and their maternal determinants during the first 5 years of life: Information from the Growing Up in New Zealand cohort

Monitoring indicators of children`s diet quality at the national level is imperative to examine if a country is on track to achieving children`s global nutrition targets and fulfilling the related Sustainable Development Goals. Despite the importance of diet quality in early life and its impact in health and wellbeing throughout the life course, Aotearoa New Zealand has limited information that is nationally representative or generalizable on children`s diet quality, especially among children under 5 years old. The only national child nutrition survey conducted to date took place two decades ago and involved children 5 years of age and older. We have previously used data collected by the Growing in Up in New Zealand cohort study, which is nationally generalizable, to partially fill historic gaps in knowledge of children`s diet and feeding practices in the first five years of life. Information on breastfeeding initiation, duration and exclusivity, timing of food introduction and whole-of-diet adherence to National Food and Nutrition Guidelines have been previously published 1–3. This work intends to complement information on NZ children`s diet quality by examining the cohort`s dietary patterns (DPs) at 9- (n = 6,259), 24- (n = 6,292), and 54-months (n = 6,131) and their maternal sociodemographic and health behaviour determinants. At all time-points, children`s DPs were identified using principal components analyses. Multivariate linear regressions were performed to examine the associations between each DP and the maternal variables. At 9-, 24- and 54-months two distinct DPs were identified, explaining, 36.4%, 35.3% and 33.6% of children`s intake variability, respectively. The Refined high in sugar and salt DP, at all time-points, was characterised by high positive loadings in white/refined breads and cereals and items with high content of sugar, sodium, and fat. At 24-months, the Refined high in sugar and salt DP also had high positive loading in the protein group. The Fruit/Vegetables DP, at all time-points, had high positive loadings for fruits and vegetables (with type varying across time-points). The Fruit/Vegetables DP had high loading in whole grain options of breads and cereals at 24-months and positive loading in the protein group at 9- and 54-months. High scores on the Refined high in sugar and salt DP at the three time-points were associated with maternal smoking habits, maternal education level, ethnicity, and maternal scores in the “Junk” and “Traditional/White bread” DPs (obtained at the antenatal maternal interview). High children’s scores on the Fruit/Vegetables DP, at all time-points, were associated with the maternal antenatal score in the “Health Conscious” DP. Findings support that policies and interventions aiming to improve early life diets in NZ should be culturally safe and support mothers’ access to formal education, healthy diets, and smoking cessation.

Exposure to Smoking as a Predictor of ADHD Subtypes Among Children Within Saudi Arabia: An Observational Study.

To explore the prevalence of maternal smoking and SHS exposure during pregnancy among mothers of children diagnosed with ADHD and investigate exposure to smoking as a predictor of ADHD subtypes. A cross-sectional study was conducted from December 1, 2022, to February 28, 2023, using an online questionnaire. The study included 217 parents of children aged 4-17 years diagnosed with ADHD and without a family history of the disorder. Data on sociodemographic determinants, academic achievement, ADHD types, and maternal smoking habits during pregnancy were collected. Among the mothers surveyed, 6.4% reported smoking during pregnancy, while 41% were exposed to SHS. The study found a predominance of the combined subtype of ADHD among the children. Logistic regression analysis revealed that families with monthly income <10000 SR were 2.6 times more likely to have a child with inattentive or hyperactive ADHD (P < 0.03). Male gender was associated with a 46% reduced likelihood of these subtypes (P < 0.03). SHS smoking and active exposure to smoking during pregnancy did not show any significant effect on ADHD. The study found that child gender and family income were significantly associated with the distribution of ADHD subtypes, while maternal smoking and SHS exposure during pregnancy did not show a significant association. The high prevalence of SHS exposure emphasizes the need for increased public health awareness and interventions to promote smoke-free environments during pregnancy.

Maternal determinants of dietary patterns in infancy and early childhood in the Growing up in New Zealand cohort

Given the importance of diet in early life, assessing children’s diet is crucial to guide interventions. Using data from a nationally generalizable New Zealand (NZ) birth cohort we examined children’s dietary patterns at 9- (n = 6259), 24- (n = 6292), and 54-months (n = 6131), and their association with maternal sociodemographic and health behaviours. At each time-point, children's dietary patterns were identified using principal components analysis. We then used multivariate linear regression to examine associations between each pattern and maternal variables. At 9-, 24- and 54-months, two dietary patterns were identified, explaining 36.4%, 35.3% and 33.6% of children's intake variability, respectively. Refined high in sugar, salt and fat dietary pattern, at all time-points, was characterized by high positive loadings in white/refined breads and cereals, and items with high sugar, sodium, and fat content. At 24-months, Refined high in sugar, salt and fat also included a high positive loading with protein food groups. Fruit and vegetables dietary pattern, at all time-points, had high positive loadings for fruits and vegetables (with type varying across time-points). Fruit and vegetables also included high loading in whole grain options of breads and cereals at 24-months and the protein food group was part of this dietary pattern at 9- and 54-months. Children’s scores on the Refined high in sugar, salt and fat pattern had strong associations with maternal smoking habits, education level, ethnicity, and maternal scores in the “Junk” and “Traditional/White bread” dietary patterns (constructed from an antenatal interview). Children’s scores on the Fruit and vegetables pattern had strong associations with the maternal scores in the dietary pattern “Health Conscious”. Interventions to improve diet in early life in NZ need to be responsive to ethnicity and suitable for people of all education levels. Interventions that improve maternal health behaviours may also improve children’s diet.

Maternal healthy lifestyle score and offspring birth outcomes: secondary analyses of the PEARS RCT

Abstract Background The influence of maternal lifestyle behaviours during pregnancy on offspring outcomes has been investigated individually. A composite Healthy Lifestyle Score (HLS) comprising low-risk protective lifestyle behaviours can be useful for studying links between overall lifestyle and health outcomes. We aimed to study links between HLS and its components in early and late pregnancy with birth outcomes among women with overweight and obesity (OWOB), as their offspring may be at increased risk for adverse birth outcomes. Methods Secondary analyses were conducted with data from the PEARS (Pregnancy Exercise And nutrition Research Study) trial, a RCT of a diet and exercise lifestyle intervention to prevent gestational diabetes. HLSs (scored 0-5) based on information about maternal diet (AHEI-P), exercise (MET-minutes), alcohol consumption, smoking, and sleep habits were created for 334 and 289 mothers in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Higher HLSs indicate a healthier overall lifestyle. Regression analyses examined associations of HLSs and individual lifestyle factors with adverse birth outcomes; low birthweight (BW), macrosomia and being born small or large for gestational age (SGA or LGA). Results Mean HLS was 3.38 in early, and 3.19 in late pregnancy. Only 12% and 10% of mothers had the maximum HLS in early and late pregnancy. Preliminary results indicated no strong links between composite HLSs and birth outcomes. Examination of the individual factors revealed that not smoking in early and late pregnancy was linked to a decreased risk for SGA (OR: 0.23, 95% CI: 0.07-0.74, p &amp;lt; 0.01; OR: 0.12, 95% CI: 0.04-0.35, p &amp;lt; 0.01) and low BW (OR: 0.11, 95% CI: 0.02-0.62, p = 0.01; OR: 0.10, 95% CI: 0.02-0.57, p = 0.01) (unadjusted results). Conclusions Adherence to a healthy lifestyle among pregnant women with OWOB can be improved. Our results highlight the importance of smoking cessation in pregnancy to avoid adverse birth outcomes. Key messages • Many pregnant women with OWOB do not adhere to a healthy lifestyle. • Smoking cessation in pregnancy is important to reduce the risk of adverse birth outcomes.

Maternal healthy lifestyle score and psychological well-being: secondary analyses of the PEARS RCT

Abstract Background The associations between lifestyle behaviours and well-being are still poorly understood, particularly in the antenatal period when women are potentially exposed to increased stress and anxiety. Moreover, lifestyle behaviours have often been investigated individually, while a Healthy Lifestyle Score (HLS) comprising low-risk protective lifestyle behaviours can be useful for studying links between overall lifestyle and health and psychosocial outcomes. Therefore, our aim was to study associations between maternal HLS in early and late pregnancy and psychological well-being. We focused on women with overweight and obesity (OWOB), as they may be at higher risk of psychosocial vulnerability. Methods Secondary analyses were conducted with data from the PEARS (Pregnancy Exercise And nutrition Research Study) trial, a randomized controlled trial of a diet and exercise lifestyle intervention with smartphone application support to prevent gestational diabetes. HLSs (scored 0-5) based on information about maternal diet (AHEI-P), exercise (MET-minutes), alcohol consumption, smoking, and sleep habits were created for 334 and 289 mothers in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Higher HLSs indicate a healthier overall lifestyle. Correlations and regression analyses examined HLS associations with well-being (WHO-5, scored 0-100) in early and late pregnancy. Results Mean pregravid BMI was 29.2. Mean well-being score was 56.3 in early and 60.7 in late pregnancy. In early pregnancy, 18% of mothers scored 0-2 on HLS, 35% scored 3, and 47% scored 4-5. In late pregnancy, this was 27%, 34% and 39% respectively. Preliminary results show significant positive associations between HLSs and well-being at both time points (r's ranging between 0.16 and 0.29, all p &amp;lt; 0.05). Conclusions Higher adherence to healthy lifestyle behaviours in mothers with OWOB was linked with higher well-being throughout pregnancy. Key messages • Many pregnant women with OWOB do not adhere to a healthy lifestyle. • Well-being and a healthy lifestyle are related throughout pregnancy.

Inequalities at birth: stable socioeconomic differences in birth outcomes in three British cohorts

In this article, I investigate the association between maternal socioeconomic status (SES) and children’s birth outcomes (birth weight) across three different birth cohorts. I also perform mediation analysis to assess the degree to which maternal smoking habits during pregnancy account for this relationship. I draw from three UK cohort studies: the 1958 National Child Developmental Study (NCDS); the 1970 British Cohort (B70); and the 2001 Millennium Cohort study (MCS). There are two main results. First, low-SES mothers are more likely to have children with poor birth outcomes and this association has remained persistent throughout the last 50 years. Second, smoking explains a large part of this association, but only in the two most recent cohorts.

Association between breastfeeding and prevalence of allergies among children in the Academy Teaching Charity Hospital, Sudan.

Background: The role of breastfeeding in the primary prevention of allergic diseases remains controversial, with hardly any reported studies from developing countries. Objective: To evaluate the association between breastfeeding and the presence of allergies. Specifically, we aimed to demonstrate the association between the exclusivity of breastfeeding and the prevalence of allergies, including asthma, eczema, allergic rhinitis, and food allergy. Secondly, to ascertain the impact of feeding cow milk as complimentary feeding on the prevalence of atopy. Finally, we intended to substantiate the association between maternal education and breastfeeding awareness. Materials and Methods: A cross-sectional study was conducted; 182 participants were enrolled. A confidential, anonymous questionnaire was administered to the participantsf mothers (those attending Academy Charity Teaching Hospital with children aged six months to 10 years). Crude associations between exclusive or non-exclusive breastfeeding and atopic diseases were evaluated using Chi-Square Test by computing crude odds ratios (OR) and corresponding 95% Confidence Interval (CI) with α level of 0.05. Multiple logistic regression models were used to estimate the effect of exclusive breastfeeding on allergic diseases. The sample was adjusted for confounding factors such as gender, family history, number of siblings, and paternal and/or maternal smoking habits. Results: Of the 182 participants included in this study, 95(52.2%) were not exclusively breastfed, and 87(47.8%) were exclusively breastfed. The prevalence of allergic diseases in the children who received non-exclusive breastfeeding compared with those with exclusive breastfeeding showed a significantly higher prevalence of atopy [OR =3.6 95%CI: 1.87-6.94] with a p-value <0.001, even more, significant when the sample was adjusted for family history [OR =4.59 95%CI: 1.96-10.75] with a p-value <0.001. Moreover, milk administration as a complementary feeding type was not significantly associated with the development of atopy [OR =1.65 95%CI: 0.87-3.14] with a p-value of 0.14. Conclusion: There is evidence that exclusive breastfeeding is protective against atopy. Mothers should breastfeed mainly for the first six months of child age and continue with partial breastfeeding beyond that age.

Dietary Fatty Acids Contribute to Maintaining the Balance between Pro-Inflammatory and Anti-Inflammatory Responses during Pregnancy.

During pregnancy, the balance between pro-inflammatory and anti-inflammatory responses is essential for ensuring healthy outcomes. Dietary Fatty acids may modulate inflammation. We investigated the association between dietary fatty acids as profiled on red blood cells membranes and a few pro- and anti-inflammatory cytokines, including the adipokines leptin and adiponectin at ~38 weeks in 250 healthy women. We found a number of associations, including, but not limited to those of adiponectin with C22:3/C22:4 (coeff -1.44; p = 0.008), C18:1 c13/c14 (coeff 1.4; p = 0.02); endotoxin with C20:1 (coeff -0.9; p = 0.03), C22:0 (coeff -0.4; p = 0.05); MCP-1 with C16:0 (coeff 0.8; p = 0.04); and ICAM-1 with C14:0 (coeff -86.8; p = 0.045). Several cytokines including leptin were associated with maternal body weight (coeff 0.9; p = 2.31 × 10-5), smoking habits (i.e., ICAM-1 coeff 133.3; p = 0.09), or gestational diabetes (i.e., ICAM-1 coeff 688; p = 0.06). In a general cohort of pregnant women, the intake of fatty acids influenced the balance between pro- and anti-inflammatory molecules together with weight gain, smoking habits, and gestational diabetes.

Association of oxytocin augmentation and duration of labour with postpartum haemorrhage: A cohort study of nulliparous women

ObjectiveBoth duration of labour and use of oxytocin for augmentation are known risk factors for postpartum haemorrhage but distinguishing between the significance of these factors is complex. In this study, we aimed to investigate the association between both labour duration and oxytocin augmentation, for postpartum haemorrhage. DesignA cohort study based on a secondary analysis of a cluster-randomised trial. Participants and settingTerm nulliparous women with a single foetus in cephalic presentation, spontaneous onset of active labour and a vaginal birth. The participants were originally included in cluster-randomised trial conducted in Norway from December 1, 2014, to January 31, 2017, that aimed to compare the frequency of intrapartum caesarean sections when adhering to the WHO partograph versus Zhang's guideline. MeasurementsThe data were analysed through four statistical models. Model 1 investigated the effect of oxytocin augmentation as a dichotomous variable (yes/no); Model 2 investigated the effect of the duration of oxytocin augmentation; Model 3 investigated the effect of the maximum dose of oxytocin; and Model 4 investigated the effect of both the duration of augmentation and the maximum dose of oxytocin. All four models included duration of labour divided into five time-intervals. We used binary logistic regression to estimate the odds ratios of postpartum haemorrhage, defined as blood loss of ≥ 1000 ml, including a random intercept for hospital and mutually adjusting for oxytocin augmentation and labour duration in addition to maternal age, maternal marital status, maternal higher education level, maternal smoking habits in the first trimester, maternal body mass index and birth weight. FindingsModel 1 found a significant association between the use of oxytocin and postpartum haemorrhage. In Model 2, oxytocin augmentation of ≥ 4.5 h was associated with postpartum haemorrhage. In Model 3, we found an association between a maximum dose of oxytocin of ≥ 20 mU/min and postpartum haemorrhage. Model 4 showed that a maximum dose of oxytocin ≥ 20 mU/min was associated with postpartum haemorrhage both for those augmented < 4.5 h and for those augmented ≥ 4.5 h. Duration of labour was associated with postpartum haemorrhage in all models if lasting ≥ 16 h. Key conclusionsWe found both oxytocin augmentation and labour duration to be associated with postpartum haemorrhage. Oxytocin doses of ≥ 20 mU/min and a labour duration of ≥ 16 h showed an independent association. Implication for practiceThe potent drug oxytocin should be carefully administered, as doses of ≥ 20 mU/min were associated with an increased risk of PPH, regardless of the duration of oxytocin augmentation.

Association of Maternal Smoking during Pregnancy with Neurophysiological and ADHD-Related Outcomes in School-Aged Children.

Data of a longitudinal cohort study were analyzed to investigate the association between prenatal tobacco exposure and electroencephalographical (EEG) power spectrum in healthy, school-aged children as well as its relationship with attention deficit hyperactivity disorder (ADHD)-related symptoms. Group comparisons (exposed, non-exposed) were performed to test whether prenatal tobacco exposure was associated with brain activity and ADHD symptoms, with adjustments made for covariates including child's sex, child's age, maternal age, maternal smoking habit before pregnancy, alcohol consumption during pregnancy, gestation age, and maternal psychopathology. Tobacco-exposed children showed higher brain activity in the delta and theta frequency bands. This effect was independent of the considered covariates. However, the effects on hyperactivity were found to significantly depend on maternal age and alcohol consumption during pregnancy, but not on the amount of exposure. In summary, smoking during pregnancy significantly affected the resting-state brain activity in children, independent of socio-demographic factors, indicating potential long-lasting effects on brain development. Its impact on ADHD-related behavior was shown to be influenced by socio-demographic confounding factors, such as maternal alcohol consumption and the age of the mother.

Does moderate to vigorous physical activity mediate the association between depression and physical function in midlife: Evidence from two British birth cohort studies

BackgroundMental health and physical health are intrinsically linked, yet the mechanisms are not well understood. We investigated whether moderate-vigorous physical activity (MVPA) mediated the association between depression and physical function (PF) in midlife. MethodsIndividuals from two UK birth cohorts born within one week in 1958 (n = 7278) and 1970 (n = 6097) with data on depression (ages 33/34; Malaise Inventory), MVPA (age 42; self-reported) and PF (ages 50/56; Short Form-36 subscale). Covariates included sex, childhood and adulthood social class, maternal mental health, childhood mood, alcohol consumption, smoking habits, sleep, marital status, BMI and long-standing illness/disability. Linear or multinomial logistic regression models examined associations between depression, MVPA and PF. We used a parametric g-computation mediation analysis approach to estimate percent differences in PF. ResultsDepression was associated with less frequent MVPA and poorer PF. Lower MVPA was associated with worse PF. The direct effect – randomised analogue not operating via MVPA – of depression on PF was −18.8 % (95%CI:--25.8,-11.8) and −15.8 % (20.6,-11.0) in the 1958 and 1970 cohorts, respectively. The indirect effect – operating via MVPA – was −0.5 % (−1.0,-0.03) and −0.2 % (−0.6, 0.3), resulting in a total proportion mediated of 3.1 % (0.1, 6.0) and 0.9 % (−1.6, 3.4). LimitationsMVPA was self-reported. Intermediate confounders and mediators were measured at the same age, however associations did not change in sensitivity analysis considering age 46 MVPA (1958 cohort). ConclusionsAlthough higher MVPA was protective against poor PF, there was only minor evidence that it mediated the association between depression and PF. Further investigation into other potential mediators of pathways from mental to physical health is needed.

A Virtual Exercise Program throughout Pregnancy during the COVID-19 Pandemic Modifies Maternal Weight Gain, Smoking Habits and Birth Weight-Randomized Clinical Trial.

The intrauterine environment is key to health from a short- and long-term perspective. Birth weight is an important indicator that may influence the fetal environment due to epigenetics. Considering physical inactivity, in parallel with higher levels of stress, affecting smoking patterns and the physical and emotional health of the pregnant population, maintaining the health of future generations is crucial. A randomized clinical trial (NCT04563065) was conducted. One-hundred and ninety-two healthy pregnant individuals were assigned to the intervention (IG) or control (CG) group. Overall, significant differences were found between groups when stratified by birth weight (χ2 (1) = 6.610; p = 0.037) with low birth weight and macrosomia found more often in the CG (4% vs. 14% and 3% vs. 9%, respectively) and higher admissions to the neonatal intensive care unit (χ2 (1) = 5.075; p = 0.024) in the CG (20/28.6%) compared to the IG (9/13.0). Smoking during pregnancy was also found more often in the CG (12/17.1%) compared to the IG (3/4.4%) (p = 0.016). A virtual program of supervised exercise throughout pregnancy during the ongoing pandemic could help to maintain adequate birth weights, modify maternal smoking habits, and lower admissions to the neonatal intensive care unit.

Impact of endocrine disorders on stillbirth: a prospective cohort study

Objective Among risk factors for SB, maternal endocrine diseases (ED), such as thyroids dysfunction and gestational diabetes mellitus (GDM), are the most frequent. This study aimed to investigate the rate of ED in a population of SB cases collected prospectively, and the relationship between these and causes of death. Methods This is an area-based, prospective cohort study conducted in Emilia-Romagna, Italy between January 2014 and December 2020. Data included all cases of SB (>22 weeks). Results From 2014 to 2020, 766 SB occurred out of a total of 232.506 births (SB rate:0.3/1000). The ED were present in 197/766 cases of SB (25.7%), respectively, 104 thyroid disease (52.8%), 74 GDM (37.5%), and 19 cases of concomitant GDM and thyroid disease (9.6%). Women who had SB associated with ED presented significantly higher mean maternal age (p < 0.001), BMI (p < 0.001), obesity (p < 0.001) and lower smoking habit (p = 0.02) respect with control group. Neonatal and placental weight of stillborn women with ED was significantly higher (p < 0.001) in respect to stillborn of the control group. Women with ED as associated condition (ReCODE classification), present significantly higher cases of SB caused by placenta pathologies (p = 0.009) namely abruptio placentae (p = 0.001) respect than control group. Conclusions ED was more frequent in older and obese women experiencing SB. The main cause of death was abruptio placentae. This information can be helpful when counseling mothers with ED and planning antenatal management to prevent SB.

Factors Affecting The Outcome of in Vitro Fertilization (IVF)

The high prevalence of infertility motivated researchers to find a solution, henceforth In Vitro Fertilization was invented. Factors that affect the outcome of IVF may include sperm analysis, maternal Body Mass Index (BMI), maternal smoking habits, endometriosis, and maternal age. However, there are ongoing debates about the role of said factors regarding the outcome of IVF. The objective of this research is to analyze those factors. This research is a Case-Control study with an analytical observational design. Data were retrieved from patients’ medical records undergoing IVF in Graha Amerta Fertility Clinic from January 2019-October 2020. First, the Chi-Square Test revealed sperm abnormality (p=0.212), Maternal BMI (p=0.427), endometriosis (p=0.067), meaning there was no connection with the outcome of IVF. Simultaneously, maternal age (p=0.037) showed a connection with the outcome of IVF. From the Binary Logistic Regression Test, maternal age 36-40 years old (p=0.044) affects the outcome of IVF significantly. Concurrently maternal BMI, endometriosis, and sperm abnormality have p value&gt;0.05 meaning it is insignificant to the outcome of IVF. This research concluded that sperm abnormality, maternal BMI, and endometriosis do not affect the outcome of IVF. There was no data about maternal smoking habits. Whilst maternal age affects the outcome of IVF. Conclusion: This research concluded that sperm abnormality, maternal BMI, and endometriosis do not affect the outcome of IVF. There was no data about maternal smoking habits. Whilst maternal age affects the outcome of IVF.

Air Pollution and Family Related Determinants of Asthma Onset and Persistent Wheezing in Children: Nationwide Case-Control Study

To identify risk factors (air pollution and family related) for the onset of asthma and persistent wheezing in children.All Danish children born from 1997 to 2014 who were managed for asthma onset and persistent wheezing from the age of 1 year to 15 years by using a national registry based, matched case-control design.Children were managed in the Danish National Patient Register for the classification of asthma or persistent wheezing after hospital discharge, or with a minimum of 2 prescriptions for asthma medications. Information regarding concentration of air pollutants (several gases, aerosols, particular matter <2.5µm [PM2.5] and particular matter <10µm), parental asthma diagnoses and asthma medication prescriptions, maternal smoking habits, highest completed parental education, and parental income levels were collected and analyzed for hazard ratios (HRs).From 1997–2014, 3 192 785 children were included in the study, and 122 842 (3.84%) children developed asthma and/or persistent wheezing, with a mean age of development of 1.9 years. Maternal asthma had a higher risk than paternal asthma (adjusted HR): 1.72 (95% CI: 1.72 to 1.77) vs 1.51 (95% CI: 1.48 to 1.53)], but having 2 parents with asthma was associated with a 2.40-fold (2.34-fold to 2.47-fold) risk of childhood asthma. Maternal smoking during pregnancy (adjusted HR: 1.23 [1.18 to 1.28]) or quitting during pregnancy (HR: 1.20 [1.18 to 1.22]) increased the risk of childhood asthma. Exposures to PM2.5, particular matter <10µm, and nitrogen dioxide were also associated with development of asthma, with PM2.5 exposure being the most consistent. Higher parental income levels, together and independently, had a reduced risk for childhood asthma (adjusted HR: 0.85 [95% CI: 0.81 to 0.89) for the highest parental income level, compared with 1.04 (95% CI: 1.00 to 1.08) for the lowest parental income level]. Higher parental education levels, together and independently, had a reduced risk for childhood asthma (adjusted HR: 0.72 [95% CI: 0.69 to 0.75]) for the highest parental education level, compared with 0.98 [95% CI: 0.95 to 1.00] for the lowest parental education level).Parental history of asthma, higher levels of exposure to PM2.5, and maternal smoking during pregnancy all increase a child’s risk of developing asthma and persistent wheezing. High levels of parental educational attainment and income are associated with a lower risk of developing asthma and persistent wheezing in children.Strengths of this study include the use of a large database that covered 18 years. In this study, researchers did not analyze atopy, lung function, or inflammatory markers. A family history of asthma, tobacco exposure and environmental pollutants were confirmed as risk factors for asthma development. Smoking cessation campaigns and environmental strategies to decrease particulate matter exposure may reduce the number of children who develop asthma.

RISK FACTORS FOR PREMATURE BIRTH IN INDONESIA

Indonesia is currently taking on the challenge of the relatively high number of neonatal deaths influencing maternal and child health. Premature birth is the most significant contributor to the number of neonatal deaths. The occurrence of premature birth is motivated by various risk factors. Knowing the magnitude of the relationship between several risks, namely maternal age, location, parity, and maternal smoking habits with preterm birth incidents was the aim of this study. The 2017 Indonesian Demographic and Health Survey (IDHS) was a source of data used. This study employed a cross-sectional approach and then processed the results with univariate and bivariate tests. The results showed a relationship between maternal age and residential area with the premature birth, where mothers under 20 years and over 35 years had a higher probability of giving birth prematurely. The area of residence, which was divided into rural and urban, also had a relationship with premature birth. The parity and smoking habits showed no association with preterm birth. Education, Antenatal Care (ANC), and other various efforts to emphasize maternal and child health care during pregnancy need to be continuously improved to reduce preterm birth rates in Indonesia.

Birth by cesarean delivery and central adiposity in adolescents from a birth cohort.

The aim of this study was to analyze the association between birth by cesarean section and central adiposity in adolescents in São Luís, Maranhão State, Brazil. This was a cohort study that included 601 participants evaluated at birth and at 18-19 years. At birth we assessed type of delivery, maternal education, family income, maternal marital status, maternal body mass index before pregnancy, prenatal care, maternal smoking habit, gestational age at delivery and intrauterine growth restriction. In the adolescents, we evaluated central adiposity using the dual X-ray energy absorptiometry method. The indicators of central fat used were the trunk-to-total fat mass ratio (T/T), the android-to-gynoid fat mass ratio (A/G), the trunk-to-limb fat mass ratio (T/Lb), and the trunk-to-leg fat mass ratio (T/Lg). A theoretical model for the study of associations was developed using directed acyclic graphs, which allowed selecting the variables that required minimum adjustment for inclusion in the predictive model of exposure to cesarean delivery. The data were analyzed with marginal structural models weighted by the inverse of the probability of selection. A total of 38.6% of the adolescents studied were delivered by cesarean section. There was no significant difference in the central adiposity of adolescents delivered by cesarean section according to the indicators used: T/T ( coefficient = -0.003; 95%CI: -0.013; 0.007), A/G (coefficient = 0.001; 95%CI: -0.015; 0.018); T/Lb (coefficient = -0.016; 95%CI: -0.048; 0.016); T/Lg (coefficient = 0.014; 95%CI: -0.060; 0.030). In conclusion, there was no association between cesarean section delivery and greater central adiposity in the studied adolescents.

Pregestational BMI and higher offspring's risk of overweight/obesity in smoker and non-smoker mothers.

To assess the association between pregestational BMI and offspring's risk of overweight/obesity after accounting for the most important confounders, especially maternal smoking habit. Prospective cohort study. The Seguimiento Universidad de Navarra (SUN) study is a prospective cohort of Spanish graduates with more than 22 000 participants nationwide. Recruitment started in 1999, and it is permanently open. Data on diet, lifestyle and clinical diagnoses are collected at baseline and every 2 years. Women from the SUN cohort who reported at least one pregnancy during follow-up (n 3496) were invited to this study. Among them, 1527 agreed to participate and completed an additional more detailed online questionnaire on their pregnancy history and their offspring's nutritional status. After excluding 165 children, we analysed data of 2791 participants born to 1485 mothers and observed that each 5 kg/m2 increase in pregestational BMI was associated with a 0·22 (95 % CI 0·15, 0·29) higher z-score in offspring's BMI and higher risk of overweight/obesity (multivariable-adjusted relative risk (RR) 1·57 (95 % CI 1·39, 1·77)) in childhood or adolescence. Furthermore, we observed stronger association in children born to smoker mothers (RR 1·91; 95 % CI 1·48, 2·46) than from non-smoker mothers (RR 1·51; 95 % CI 1·31, 1·73) (Pfor interaction = 0·02). We found a synergistic interaction between pregestational BMI and maternal smoking habit on offspring's z-score of the BMI and in their risk of overweight/obesity. Although further research is needed to analyse dose-response relationships, these findings reinforce the importance of promoting healthy lifestyles in pregnant women in order to prevent childhood obesity.

Analisis Faktor Sosiodemografi Kejadian Persalinan Preterm di RSUP Dr. Mohammad Hoesin Palembang Tahun 2019

Preterm labor is delivery that occurs less than 37 weeks or 259 days after gestation or birth weight of the fetus of less than 2,500 grams. Sociodemographic factors influence the implementation of preterm labor. This study aims to determine the relationship between sociodemographic factors including age, occupation, education, maternal smoking and alcohol habits on the incidence of preterm labor at Dr. Mohammad Hoesin Central Hospital Palembang in 2019. This research is a quantitative study using a cross sectional design with a sample size of 317 respondents with a systematic random sampling technique. Data collection was done by viewing and recording maternal data in medical records, on variables of maternal age, maternal occupation, smoking habits, drinking alcohol habits and preterm labor using a checklist designed by the researcher. This research was conducted at Dr. Mohammad Hoesin Central Hospital Palembang from July to August 2020. Data were analyzed using the chi square test. The results of the analysis showed that there was a relationship between maternal occupation and the incidence of preterm labor (p value = 0.045 &lt;0.05) with an OR value of 0.528, meaning that working mothers had a 0.528 times more risk of experiencing preterm labor than non-working mothers. Simple logistic regression analysis concluded that working mothers had a risk of experiencing preterm labor by 63,94%. Of the five sociodemographic factors measured in this study, maternal occupational factors have a relationship between incidence of preterm labor. These results can be used as a basis for information on promotional measures and to prevent the incidence of preterm labor.

Smoking during pregnancy. Results of the cross-sectional KiGGS Wave 2 study and trends

Abstract Background Maternal smoking during pregnancy represents a significant risk, increasing the adverse consequences for mothers and newborns. Different national targets have been developed in Germany to reduce smoking rates during pregnancy. To monitor the achievement of these goals, this study aims to assess social differences and temporal trends of smoking behaviour during pregnancy in mothers living in Germany. Methods Data of children aged 0 to 6 with valid information on maternal smoking habits during pregnancy were subtracted from German Health Interview and Examination Survey for Children and Adolescents (KiGGS)(KiGGS baseline 2003-2006, n = 6,525 and KiGGS wave 2 2014-2017, n = 4,838). The information on maternal smoking during pregnancy was recorded retrospectively as part of a self-administered written questionnaire. We estimated the prevalence of smoking in pregnancy and multivariable logistic regression models to assess the association with the age of the mother at the time the child was born, the socioeconomic status of the family and the migration background. In addition, to analyse trends over time, we compare the current data with the KiGGS baseline study. Results The prevalence of mothers who smoked during pregnancy decreased statistically significant from 19.9% (KiGGS baseline) to 10.9% (KiGGS wave 2). Younger mothers aged up to 24 years were more likely to smoke during pregnancy (OR 1.74; 95%CI 1.04-2.89), similar to those with intermediate (OR 5.52; 95%CI 2.90-10.48) or low socioeconomic status (OR 22.43; 95%CI 10.84-46.39), and those without (OR 4.18; 95%CI 2.27-7.70) or with one-sided migration background (OR 2.47; 95%CI 1.26-4.84), in comparison to the groups of reference. Conclusions Our findings, present the reduction of smoking prevalence during pregnancy, recognising the effectiveness of the tobacco control programs in Germany. However, more emphasis on the prevention strategies for young and socially disadvantaged women are still required. Key messages Smoking prevalence during pregnancy has decreased in Germany over time, though still represents a challenge for public health and tobacco control. The prevention strategies should reduce the social breach, to extend the benefit among women and their offspring.