Maternal Social Factors Research Articles

The Association of Social Factors and Time Spent in the NICU for Mothers of Very Preterm Infants.

Evaluate the association between maternal social factors and maternal time spent in the NICU for very preterm infants admitted to 4 level III and IV NICUs. In this prospective observational cohort study, we enrolled mother-infant dyads whose infants were born <32 weeks' gestation. Enrollment occurred after 2 weeks of NICU exposure, when maternal social factors and demographic information was collected. Maternal time spent in the NICU was abstracted from the electronic medical record and was dichotomized into 0 to 6 days and ≥6 days per week. Demographic differences between the 2 groups were compared by using χ2 tests. Logistic regression was used to assess the independent association between maternal social factors and the average number of days per week spent in the NICU. A total of 169 mother-infant dyads were analyzed. Maternal social factors associated with more time spent in the NICU included an annual household income of >$100 000, compared with those with an annual household income of <$50 000 (adjusted odds ratio [aOR]: 5.68; 95% confidence interval [CI] 1.77-18.19), a travel time <30 minutes to the NICU (compared with those who traveled >60 minutes [aOR: 7.85; 95% CI 2.81-21.96]), and the lack of other children in the household, compared with women with other children (aOR: 3.15; 95% CI 1.39-7.11). Maternal time spent in the NICU during a prolonged birth hospitalization of a very preterm infant differed by socioeconomic status, travel time, and presence of other dependents. Strategies to better identify and reduce these disparities to optimize engagement and, subsequently, improve infant health outcomes is needed.

Barriers and benefits to breastfeeding with gestational diabetes

Gestational diabetes mellitus (GDM) is a disease of glucose intolerance during pregnancy and is associated with infant macrosomia, infant hypoglycemia, and increased risk of type 2 diabetes development for both mother and infant. Although breastfeeding potentially mitigates metabolic sequelae for both mother and her offspring, women with GDM are more likely to introduce formula and, therefore, are less likely to exclusively breastfeed, and some studies show less initiation and shorter breastfeeding duration as well. Therefore, women with GDM and their infants warrant investigation of methods by which to increase breastfeeding exclusivity and duration. Exploration of the barriers to breastfeeding for women with GDM demonstrate not only biologic complications such as maternal obesity, increased prevalence of cesarean section, and infant hypoglycemia, but also maternal report of less provider support of breastfeeding and reduced breastfeeding self-efficacy. Consequently, interventions designed to optimize breastfeeding outcomes in this high-risk population should not only focus on the biology but also on provider behavior and maternal social factors.

The impact of prematurity and maternal socioeconomic status and education level on achievement-test scores up to 8th grade.

BackgroundThe relative influence of prematurity vs. maternal social factors (socioeconomic status and education level) on academic performance has rarely been examined.ObjectiveTo examine the impact of prematurity and maternal social factors on academic performance from 3rd through 8th grade.MethodsWe conducted a retrospective cohort study of infants born in 1998 at the University of Arkansas for Medical Sciences. The study sample included 58 extremely low gestational age newborns (ELGANs, 23‒<28 weeks), 171 preterm (≥28‒<34 weeks), 228 late preterm (≥34‒<37 weeks), and 967 term ((≥37‒<42 weeks) infants. Neonatal and maternal variables were collected including maternal insurance status (proxy measure for socioeconomic status) and education level. The primary outcomes were literacy and mathematics achievement-test scores from 3rd through 8th grade. Linear mixed models were used to identify significant predictors of academic performance. All two-way interactions between grade level, gestational-age (GA) groups, and social factors were tested for statistical significance.ResultsPrematurity, social factors, gender, race, gravidity, and Apgar score at one minute were critical determinants of academic performance. Favorable social factors were associated with a significant increase in both literacy and mathematic scores, while prematurity was associated with a significant decrease in mathematic scores. Examination of GA categories and social factors interaction suggested that the impact of social factors on test scores was similar for all GA groups. Furthermore, the impact of social factors varied from grade to grade for literacy, while the influence of either GA groups or social factors was constant across grades for mathematics. For example, an ELGAN with favorable social factors had a predicted literacy score 104.1 (P <.001), 98.2 (P <.001), and 76.4 (P <.01) points higher than an otherwise similar disadvantaged term infant at grades 3, 5, and 8, respectively. The difference in their predicted mathematic scores was 33.4 points for all grades (P <.05).ConclusionWhile there were significant deficits in academic performance for ELGANs compared to PT, LPT, and term infants, the deficit could be offset by higher SES and better-educated mothers. These favorable social factors were critical to a child’s academic achievement. The role of socioeconomic factors should be incorporated in discussions on outcome with families of preterm infants.

Maternal Risk Factors Associated with Low Birth Weight Neonates in a Tertiary Care Hospital, Northern India

Low birth weight is influenced by many socio-economic factors like habitat, urban or rural, education, birth order, substance abuse by mother, religion and caste, age of mother nutritional status of mother, Body Mass Index, Hemoglobin level etc., quality of ante-natal care received (ANC) and spacing of pregnancies. Low birth weight babies pose challenge to the families and communities. They contribute major share in perinatal and neonatal mortality and also towards mental, physical and development challenges in pediatric population. Objective: To assess the impact of maternal social factors on the birth weight of newborn. Study setting: This study was conducted in a tertiary care hospital attached to Subharti medical college of Meerut District. Study design: Hospital based Cross sectional study. Study population: 325 women delivering live infants in the study setting. Study period: Six months i.e. from January 2011 to June 2011. Material and methods: All 325 mothers who delivered live infants in a tertiary care hospital attached to Subharti medical college, Meerut District were interviewed. Data was collected on a structured, pre-designed and pre-tested questionnaire. Statistical analysis: Data was entered in Microsoft Excel and the results were expressed as proportions. Results: The overall prevalence of LBW neonates was 32.3%. Majority (71.42%) of mothers was living in rural areas and 52.39% of the mothers belonged to joint families. 52.39% of the mothers were illiterate. Majority of mothers (76.19%) were housewives and their socio-economic status was IVth class (47.61%). The highest prevalence of LBW was found among mothers aged <18 years (42.86%), addicted to tobacco chewing (53.33%) and smoking (33.33%). Among mothers with pre pregnancy weight was less than 40 kg seen in 80.96%. Prevalence was seen (47.61%) of LBW was inversely proportional to the 6.0-8.0 gm Hemoglobin level and Primiparous mothers was found to be (42.86 %) and in parity of >5 (23.80%). Conclusion: Birth weight remained an important factor affecting the neonatal infant and childhood mortality and morbidity. Low birth weight babies are more likely to have disabilities in four of developmental delay, poor growth and mental disabilities. For reducing the prevalence of low birth weight, public health strategy needs to focus attention on better maternal nutrition and education.

The association of maternal social factors and antenatal care with cord serum zinc in full – term neonates

Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on consecutive mothers with normal pregnancy(excluding sepsis and chronic illneses) and cord serum level of Zinc estimation in newborns using flame atomic absorption spectrophotometry. There were 106 mothers and neonates; were made up of 57 females and 49 males. The ages of the mother ranged between 21 years to 39 years, with a mean of 26 years; while the gestational age of the neonates ranged between 30 weeks and 45 weeks with a mean of 37.3. The range of the serum Zinc was 0.14μg/L – 0.92μg/L, with a mean of 0.64μg/L (SD=0.17) and median value of 0.63μg/L. The social classes of the mothers were low 66, middle 23 and high 17 with mean neonatal serum zinc of 0.62μg/L, 0.68μg/L and 0.72μg/L. The mean serum Zinc in 17/86 neonates of mothers with inadequate tetanus vaccination was 0.53μg/L, (below the median value) compared to 0.66μg/L in 89/106 neonates of mothers with complete vaccination. The serum zinc in the neonates of mothers 25years. Fever in pregnancy was seen in 31/106; with mean neonatal serum Zinc of 0.63μg/L compared with those without fever 0.65μg/L. There were 94 neonates with normal weight (>2.5kg) and 12 low birth weight ( Key word: neonates, serum zinc, maternal social classes, antenatal care, association