Maternal Socioeconomic Status Research Articles

Do maternal socioeconomic status influence child overweight?

The prevalence of overweight among Chinese children under 5 years of age has been increasing steadily. Using data from China Health and Nutrition Survey (CHNS) spanning from 1991 to 2015, this study investigates the relationship between maternal employment status, maternal education level, and the prevalence of child overweight among Chinese children under 5 years old. The findings indicate that having mothers with low middle school education significantly reduces their children's body mass index z-scores (BMIZ) (p < 0.05). However, no significant association is observed between maternal education level and childhood overweight in urban areas. In rural areas, only when the maternal education level is college or above, there is a significant increase in BMIZ (p < 0.01). The impact of maternal education level on childhood obesity is influenced by household per capita income, and when household per capita income reaches a certain level, higher maternal education is negatively associated with child BMIZ. The study also reveals a significant negative association between maternal employment (p < 0.01)，average weekly working days (p < 0.01), and the BMIZ of children under 5 years of age, while the interaction effect between them is positive and significant. This study has recommended some policy interventions, by promoting parental education on child feeding and parenting, providing professional child care, and offering financial subsidies to families with children under 5.

Association between maternal oral bacteria with early childhood caries development in their children

Objective: The objective of this prospective study was to investigate the association between maternal oral bacteria and the development of early childhood caries (ECC) in their children over a two-year period. Methods: A cohort of mothers and their children was recruited during the prenatal period. Maternal oral samples were collected to assess the presence and abundance of specific cariogenic bacteria, including Streptococcus mutans and Lactobacillus species, using polymerase chain reaction (PCR) techniques. The children were followed up at regular intervals from birth until two years of age. Oral examinations were conducted to assess the presence and severity of ECC. Statistical analyses was performed to determine the association between maternal oral bacteria and ECC development in their children. Results: The study included 98 mother-child pairs, with an average follow-up period of 24 months. The results demonstrated a significant association between maternal oral bacteria and ECC development in their children. Maternal colonization of cariogenic bacteria, particularly S. mutans, was found to be a strong predictor of ECC development in their offspring, even after adjusting for confounding factors such as maternal oral hygiene, socioeconomic status, and child's diet. Higher levels of S. mutans in maternal oral samples were associated with an increased risk of ECC in children at two years of age. Conclusion: This prospective study provides evidence for an association between maternal oral bacteria and the development of early childhood caries in their children over a two-year period. Maternal colonization of cariogenic bacteria, especially Streptococcus mutans, was found to be a significant risk factor for ECC development. These findings highlight the importance of maternal oral health and the need for preventive measures targeting maternal oral bacteria to reduce the transmission and subsequent development of ECC in children. Early interventions, including oral hygiene education and preventive strategies, should be implemented to promote maternal oral health and improve oral health outcomes in children.

Predicting child development and school readiness, at age 5, for Aboriginal and non-Aboriginal children in Australia's Northern Territory.

Positive early development is critical in shaping children's lifelong health and wellbeing. Identifying children at risk of poor development is important in targeting early interventions to children and families most in need of support. We aimed to develop a predictive model that could inform early support for vulnerable children. We analysed linked administrative records for a birth cohort of 2,380 Northern Territory children (including 1,222 Aboriginal children) who were in their first year of school in 2015 and had a completed record from the Australian Early Development Census (AEDC). The AEDC measures early child development (school readiness) across five domains of development. We fitted prediction models, for AEDC weighted summary scores, using a Partial Least Square Structural Equation Model (PLS-SEM) considering four groups of factors-pre-pregnancy, pregnancy, known at birth, and child-related factors. We first assessed the models' internal validity and then the out-of-sample predictive power (external validity) using the PLSpredict procedure. We identified separate predictive models, with a good fit, for Aboriginal and non-Aboriginal children. For Aboriginal children, a significant pre-pregnancy predictor of better outcomes was higher socioeconomic status (direct, β = 0.22 and indirect, β = 0.16). Pregnancy factors (gestational diabetes and maternal smoking (indirect, β = -0.09) and child-related factors (English as a second language and not attending preschool (direct, β = -0.28) predicted poorer outcomes. Further, pregnancy and child-related factors partially mediated the effects of pre-pregnancy factors; and child-related factors fully mediated the effects of pregnancy factors on AEDC weighted scores. For non-Aboriginal children, pre-pregnancy factors (increasing maternal age, socioeconomic status, parity, and occupation of the primary carer) directly predicted better outcomes (β = 0.29). A technical observation was that variance in AEDC weighted scores was not equally captured across all five AEDC domains; for Aboriginal children results were based on only three domains (emotional maturity; social competence, and language and cognitive skills (school-based)) and for non-Aboriginal children, on a single domain (language and cognitive skills (school-based)). The models give insight into the interplay of multiple factors at different stages of a child's development and inform service and policy responses. Recruiting children and their families for early support programs should consider both the direct effects of the predictors and their interactions. The content and application of the AEDC measurement need to be strengthened to ensure all domains of a child's development are captured equally.

Impact of Biophysical Profile (BPP) Score on Method of Delivery

Introduction: This study aims to investigate the impact of Biophysical Profile (BPP) scores on the method of delivery and perinatal outcomes in a Bangladeshi context. Considering the significant role of maternal age, socio-economic status, and occupational factors in perinatal health, this research provides insights into how these variables interact with BPP scores to influence delivery methods and perinatal outcomes. Methods: This cross-sectional observational study was conducted with 150 pregnant women at or above 36 weeks of gestation. Participants were selected through purposive convenient sampling from outpatient and admission departments. The study assessed demographic details, BPP scores, mode of delivery, and perinatal outcomes. Statistical analysis was performed using SPSS, with a focus on the association between BPP scores and delivery methods, as well as perinatal outcomes. Result: The study population predominantly consisted of younger women, with 62.00% aged between 18-25 years and 22.67% between 26-30 years. Regarding BPP scores, 75.33% had a score of 10, 14.67% had a score of 8, and 10.00% had a score of 6. No significant correlation was found between BPP scores and the method of delivery (p-value = 0.393). However, a significant association was observed between lower BPP scores and adverse perinatal outcomes: 53.33% of participants with a BPP score of 6 experienced birth asphyxia, and 20.00% faced neonatal death. In contrast, 97.35% of participants with a BPP score of 10 had healthy babies. Conclusion: The study highlights the complex interplay of BPP scores, socio-economic and demographic factors in determining perinatal outcomes and delivery methods. It underscores the need for a holistic approach in obstetric care, integrating BPP scores with a comprehensive understanding of each patient's socio-economic and cultural context. This approach is crucial for optimizing delivery methods and improving perinatal outcomes in similar settings.

A cross-sectional study of feeding practice status in children (6–23 months), association with malnutrition, and impacts of maternal determinants

Background: Inadequate complementary feeding practices lead to poor cognition, stunting, and increased rate of infections. Insight into deficiencies of complementary feeding practices could help in planning and implementing newer approaches at various levels of intersection. Aims and Objectives: The aim and purpose of the study were to determine the complementary feeding practices, to identify maternal determinants of each practice, and to analyze the associations between complementary feeding practices with malnutrition. Materials and Methods: A prospective observational study was conducted at the Department of Pediatrics, of a tertiary hospital over a 14-week period. All children aged 6–23 months were included in the study. Data were collected using a pre-structured questionnaire based on the World Health Organization Infant and Young Child Feeding (IYCF) indicators for assessing IYCF practices. Results: A total of 400 mothers participated in the study. The mean age of children was 12.58 20±5.02 months, male: female = 1.6:1. The mean age of starting complementary feeding was 6.81±1.79 months. Semisolid food was introduced in 90.2% of children, minimum dietary diversity was received by 61.0%, minimum meal frequency by 83.8%, and minimum acceptable diet by 58.2%, eggs and flesh by 14.2% and 3.5% children, respectively; only 9.2% received vitamin A rich fruits and 38.5% did not receive any vegetable or fruit. Bottle feeding was present in 55.5% of population. Maternal parameters (education, employment access to media) and socioeconomic status were significantly associated with feeding practices (P&lt;0.05). A significant difference was found in the nutritional status (wasting and stunting) of children who did not receive minimum dietary diversity (P&lt;0.01). Conclusion: Wide gap exists in feeding practices even in urban settings and was significantly associated with child’s nutritional status.

Maternal reminiscing during middle childhood: Associations with maternal personality and child temperament from the Growing Up in New Zealand cohort study.

The way that mothers talk about the past (reminisce) with young children is linked to key memory, language, and socioemotional outcomes. The present research explored the role of a range of child, maternal, socioeconomic, and cultural factors that predict maternal reminiscing style, with a particular focus on maternal personality and child temperament. A total of 1,404 mother-child dyads from the prebirth longitudinal cohort study Growing Up in New Zealand (https://www.growingup.co.nz) participated in a reminiscing task about a negative event when children were 8 years old. This broader cohort is broadly representative of the New Zealand population in terms of maternal ethnicity and socioeconomic status. Conversations were scored using a revised version of the Elaborative Reminiscing Scale. Child temperament during infancy, but not childhood, uniquely predicted maternal reminiscing style. Maternal extraversion also predicted a more elaborative reminiscing style. Other maternal factors, including education, ethnicity, and age, were also identified as unique predictors of maternal reminiscing style. These findings fit well with an ecological systems view of maternal reminiscing as a function of child, maternal, and cultural factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Socioeconomic characteristics and domestic work as correlates of family satisfaction in Hong Kong mothers of young children

BackgroundFamily life satisfaction is an important contributor to the mental health of mothers with young children, who are particularly vulnerable to various sources of stressors. However, there is a dearth of studies on this topic in this demographic, the determinants of which likely differ across geographical and cultural contexts. We examined indicators of maternal socioeconomic status (SES) and domestic help as correlates of family satisfaction in Hong Kong mothers of young children.MethodsMothers (N = 322) of young children (3–5 years old) were recruited from neighbourhoods stratified by SES and population density. They self-completed a survey containing items on socio-demographics, SES characteristics (including household income and maternal education and employment status), maternal family satisfaction and division of domestic work in the household and family. Confounder-adjusted associations of maternal SES indicators and participation in housework and childcare activities by various agents (e.g., mother, spouse, other residents) were estimated. We also estimated the moderating effects of household income on the associations between maternal employment and family satisfaction, and those of maternal employment on the associations between domestic work division and family satisfaction.ResultsHousehold income and maternal education were positively related to maternal family satisfaction. Mothers in part-time employment had lower family satisfaction than non-working mothers and mothers working full-time. The latter reported higher family satisfaction than non-working mothers only if their household income was below HK$ 15,000. Domestic work performed by non-residents was predictive of higher family satisfaction, while mothers’ housework and child(ren) tutoring were predictive of lower family satisfaction. Only part-time employed mothers benefited from spouse’s assistance with domestic work. The interaction effects of maternal employment status on the associations between the division of child tutoring and family satisfaction were complex.ConclusionsIn Hong Kong, mothers of young children with lower education and household income, who hold a part-time job and participate in housework and child tutoring activities have the lowest levels of family satisfaction and, hence, are at higher risk of mental health problems. Spouses’ and non-resident family members’ participation in domestic work, as well as the establishment of more family-friendly employment practices, may help mitigate this risk.Trial registrationN/A.

Neurodevelopmental Outcomes in Preterm Babies: A 12-Month Observational Study.

Background Preterm births are a significant concern worldwide due to their association with both short- and long-term morbidity. Modern neonatal intensive care techniques have improved the survival of infants born at the brink of viability. However, there remain significant challenges concerning their neurodevelopment. A considerable proportion of very low birth weight infants exhibit significant motor deficits such as cerebral palsy or cognitive, behavioral, or attention disabilities. The consequences of these impairments, particularly given their life-long nature, can be severe for the affected individuals, families, and public health resources. Consequently, timely neurodevelopmental assessment is critical in recognizing delayed development and selecting infants for neurodevelopmental stimulation. This study aimed to estimate the neurodevelopment of preterm infants, identify influencing factors, detect at-risk groups, and refer/recommend early intervention when developmental delays are observed. Methodology This prospective, observational, hospital-based study done in the department of pediatrics, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Gotri, Vadodara, Gujrat, India included inborn and outborn preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) or the Sick Newborn Care Unit from their first day of life. The study period was from October 2020 to January 2021, and only neonates with an uncomplicated clinical course were included. Newborns were enrolled in a high-risk clinic, and follow-up appointments were scheduled at three, six, nine, and 12 months of corrected gestational age (CGA). We used the Baroda Developmental Screening Tool (BDST) to calculate the developmental quotient (DQ) at each appointment. This assessment involved parental interviews, observation of developmental milestones, and simple test demonstrations. The gathered DQ data at different ages were analyzed and compared across groups. Results Of 100 preterms enrolled, 62 preterms were followed up until 12 months of CGA. Thirteen patients out of the 62(approximately one-fifth) preterm neonates exhibited developmental delays at one year of CGA, most of whom were early preterm infants. Twenty-six patients (approximatelytwo-fifths) were delayed at three months of CGA, and thus 13 patients (half) showed catch-up growth and development. There was no statistically significant difference between the neurodevelopment of female and male infants. However, infants born to mothers with better socioeconomic status and higher education showed improved neurodevelopment. Conclusions Our study findings suggest that preterm infants discharged from the NICU exhibit poor neurodevelopmental outcomes, especially those born early preterm. This pattern indicates an inverse relationship between neurodevelopmental delay and the maturity of the neonate. Maternal education and socioeconomic status positively impacted the neurodevelopment of preterm NICU graduates. Thus, regularfollow-up (at least once every three months), early detection by a screening scale like the BDSTand intervention significantly improved neurodevelopmental outcomes.

Omega-3 Polyunsaturated Fatty Acid Levels in Maternal and Cord Plasma Are Associated with Maternal Socioeconomic Status.

Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) play a crucial role in fetal growth and neurodevelopment, while omega-6 (n-6) PUFAs have been associated with adverse pregnancy outcomes. Previous studies have demonstrated that socioeconomic status (SES) influences dietary intake of n-3 and n-6 PUFAs, but few studies have evaluated the association between maternal and cord plasma biomarkers of PUFAs and socioeconomic markers. An IRB-approved study enrolled mother-infant pairs (n = 55) at the time of delivery. Maternal and cord plasma PUFA concentrations were analyzed using gas chromatography. Markers of SES were obtained from validated surveys and maternal medical records. Mann-Whitney U tests and linear regression models were utilized for statistical analysis. Maternal eicosapentaenoic acid (EPA) (p = 0.02), cord EPA (p = 0.04), and total cord n-3 PUFA concentrations (p = 0.04) were significantly higher in college-educated mothers vs. mothers with less than a college education after adjustment for relevant confounders. Insurance type and household income were not significantly associated with n-3 or n-6 PUFA plasma concentrations after adjustment. Our findings suggest that mothers with lower educational status may be at risk of lower plasma concentrations of n-3 PUFAs at delivery, which could confer increased susceptibility to adverse pregnancy and birth outcomes.

Effects of Prenatal Stress on Behavior, Cognition, and Psychopathology: A Comprehensive Review.

Prenatal stress is increasingly recognized as a significant factor impacting an individual's life from the beginning. This comprehensive review explores the intricate relationship between prenatal stress and its effects on behaviour, cognition, and psychopathology. Key findings reveal that prenatal stress can lead to a wide range of adverse outcomes in offspring, including neurodevelopmental disorders, emotional dysregulation, cognitive deficits, mood disorders, and an increased risk of psychopathological conditions. These effects' mechanisms involve epigenetic modifications, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, neurodevelopmental alterations, inflammatory processes, and changes in brain structure and function. Moreover, moderating factors such as maternal stress levels, maternal mental health, socioeconomic status, social support, and early-life adversity can significantly influence the impact of prenatal stress. The review also discusses intervention and prevention strategies, emphasizing the importance of prenatal stress reduction programs, maternal mental health support, nutritional interventions, and targeted early interventions for at-risk populations. These findings have substantial implications for public health and clinical practice, highlighting the need for a holistic approach to prenatal care that prioritizes maternal well-being and mitigates the lasting effects of prenatal stress. Addressing this critical issue promises healthier generations and stronger communities in the future.

Maternal prenatal social experiences and offspring epigenetic age acceleration from birth to mid-childhood

PurposeInvestigate associations of maternal social experiences with offspring epigenetic age acceleration (EAA) from birth through mid-childhood among 205 mother-offspring dyads of minoritized racial and ethnic groups. MethodsWe used linear regression to examine associations of maternal experiences of racial bias or discrimination (0 = none, 1–2 = intermediate, or 3+ = high), social support (tertile 1 = low, 2 = intermediate, 3 = high), and socioeconomic status index (tertile 1 = low, 2 = intermediate, 3 = high) during the prenatal period with offspring EAA according to Horvath’s Pan-Tissue, Horvath’s Skin and Blood, and Intrinsic EAA clocks at birth, 3 years, and 7 years. ResultsIn comparison to children of women who did not experience any racial bias or discrimination, those whose mothers reported highest levels of racial bias or discrimination had lower Pan-Tissue clock EAA in early (−0.50 years; 90% CI: −0.91, −0.09) and mid-childhood (−0.75 years; −1.41, −0.08). We observed similar associations for the Skin and Blood clock and Intrinsic EAA. Maternal experiences of discrimination were not associated with Pan-Tissue EAA at birth. Neither maternal social support nor socioeconomic status predicted offspring EAA. ConclusionsChildren whose mothers experienced higher racial bias or discrimination exhibited slower EAA. Future studies are warranted to confirm these findings and establish associations of early-life EAA with long-term health outcomes.

Risk Factors Associated With Maternity Blues and Postpartum Depression in Ecuadorian Women Going Through Their Immediate Puerperium During 2021: A Cross-sectional Study

IntroductionPerinatal factors such as lack of breastfeeding, complications during pregnancy or childbirth, and psychosocial factors such as maternal psychiatric history or socioeconomic status have been associated with the development of postpartum mood disorders. The combination of these factors during the peripartum can predict the development of maternity blues (MB) and postpartum depression (PD). ObjectiveTo characterize risk factors associated with MB and PD in Ecuadorian women going through their immediate puerperium in the gynecology and obstetrics service of “Hospital General San Francisco” in Quito-Ecuador. MethodA cross-sectional study was conducted, with a sample of 250 women attending their immediate puerperium. Data was collected using a self-applied questionnaire during the first 24 postpartum hours. Stein blues scale (SBS) was applied for MB screening and the Edinburgh Postpartum Depression Scale (EPDS) for PD screening. Informed consent and data confidentiality were explained to all participants. ResultsUsing the SBS, a probability of MB of 32.4% (n=81) was observed, while applying the EPDS, a PD probability of 17.6% (n=44) was established. MB and PD protective factors were rooming-in (OR .21, p<.001) (OR .21, p<.001), pregnancy planning (OR .13, p<.001) (OR .25, p<.001) and breastfeeding (OR .20, <.001) (OR .23, p<.001). Meanwhile MB and PD risk factors found were: breastfeeding difficulties (OR 5.88, p<.001) (OR 5.14, p<.001), complications during pregnancy (OR 8.39, p<.001) (OR 7.02, p<.001), complications during delivery (OR 5.29, p<.001) (OR 5.58, p<.001) and economic instability (OR 2.10, p .023) (OR 2.61, p .009). Discussion and conclusionThe risk and protective factors associated with MB and PD in the Ecuadorian population are similar to those described internationally. The recognition of risk factors by health personnel can improve early identification and timely management of puerperal mood disorders.

Predictors of height in Romanian infants 6-23 months old: findings from a national representative sample.

The research explored the association between infants' height and various demographic factors in Romania, a country where such critical information has been lacking. This study was conducted on a nationally representative sample and used a family physicians database to determine a sample of 1532 children (713 girls and 819 boys) 6-23 months of age (M=14.26; SD=5.15). Infants' height-for-age z-scores (HAZ) were calculated using the World Health Organization's computing algorithm. A multiple regression analysis was conducted to investigate whether certain risk factors, such as infant mother's age, location, marital status, socioeconomic status (SES), as well as infant's term status at birth, age, anemia, minimum dietary diversity (MDD) and birth order, could significantly predict the HAZ. The study identified several significant predictors of height. Specifically, lower HAZ was associated with rural living, preterm birth, age 18-23 months, unmarried mothers, anemia, lack of MDD and being third or later born in the family. In contrast, higher HAZ was associated with medium or high maternal SES and older maternal age. The study underscores the importance of addressing these significant risk factors through distinct interventions to improve height outcomes in at-risk Romanian populations.

National Trends in Preterm Infant Mortality in the United States by Race and Socioeconomic Status, 1995-2020

Inequalities in preterm infant mortality exist between population subgroups within the United States. To characterize trends in preterm infant mortality by maternal race and socioeconomic status to assess how inequalities in preterm mortality rates have changed over time. This was a retrospective longitudinal descriptive study using the US National Center for Health Statistics birth infant/death data set for 12 256 303 preterm infant births over 26 years, between 1995 and 2020. Data were analyzed from December 2022 to March 2023. Maternal characteristics including race, smoking status, educational attainment, antenatal care, and insurance status were used as reported on an infant's US birth certificate. Preterm infant mortality rate was calculated for each year from 1995 to 2020 for all subgroups, with a trend regression coefficient calculated to describe the rate of change in preterm mortality. The average US preterm infant mortality rate (IMR) decreased from 33.71 (95% CI, 33.71 to 34.04) per 1000 preterm births per year between 1995-1997, to 23.32 (95% CI, 23.05 to 23.58) between 2018-2020. Black non-Hispanic infants were more likely to die following preterm births than White non-Hispanic infants (IMR, 31.09; 95% CI, 30.44 to 31.74, vs 21.81; 95% CI, 21.43 to 22.18, in 2018-2020); however, once born, extremely prematurely Black and Hispanic infants had a narrow survival advantage (IMR rate ratio, 0.87; 95% CI, 0.84 to 0.91, in 2018-2020). The rate of decrease in preterm IMR was higher in Black infants (-0.015) than in White (-0.013) and Hispanic infants (-0.010); however, the relative risk of preterm IMR among Black infants compared with White infants remained the same between 1995-1997 vs 2018-2020 (relative risk, 1.40; 95% CI, 1.38 to 1.44, vs 1.43; 95% CI, 1.39 to 1.46). The rate of decrease in preterm IMR was higher in nonsmokers compared with smokers (-0.015 vs -0.010, respectively), in those with high levels of education compared with those with intermediate or low (-0.016 vs - 0.010 or -0.011, respectively), and in those who had received adequate antenatal care compared with those who did not (-0.014 vs -0.012 for intermediate and -0.013 for inadequate antenatal care). Over time, the relative risk of preterm mortality widened within each of these subgroups. This study found that between 1995 and 2020, US preterm infant mortality improved among all categories of prematurity. Inequalities in preterm infant mortality based on maternal race and ethnicity have remained constant while socioeconomic disparities have widened over time.

DNA methylation at the suppressor of cytokine signaling 3 (SOCS3) gene influences height in childhood

Human height is strongly influenced by genetics but the contribution of modifiable epigenetic factors is under-explored, particularly in low and middle-income countries (LMIC). We investigate links between blood DNA methylation and child height in four LMIC cohorts (n = 1927) and identify a robust association at three CpGs in the suppressor of cytokine signaling 3 (SOCS3) gene which replicates in a high-income country cohort (n = 879). SOCS3 methylation (SOCS3m)—height associations are independent of genetic effects. Mendelian randomization analysis confirms a causal effect of SOCS3m on height. In longitudinal analysis, SOCS3m explains a maximum 9.5% of height variance in mid-childhood while the variance explained by height polygenic risk score increases from birth to 21 years. Children’s SOCS3m is associated with prenatal maternal folate and socio-economic status. In-vitro characterization confirms a regulatory effect of SOCS3m on gene expression. Our findings suggest epigenetic modifications may play an important role in driving child height in LMIC.

Socioeconomic status and risk for child psychopathology: exploring gene-environment interaction in the presence of gene-environment correlation using extended families in the Norwegian Mother, Father and Child Birth Cohort Study.

Low socioeconomic status (SES) is associated with increased risk for emotional and behavioural problems among children. Evidence from twin studies has shown that family SES moderates genetic and environmental influences on child mental health. However, it is also known that SES is itself under genetic influence and previous gene-environment interaction (G×E) studies have not incorporated the potential genetic overlap between child mental health and family SES into G×E analyses. We applied a novel approach using extended family data to investigate the moderation of aetiological influences on child emotional and behavioural problems by parental socioeconomic status in the presence of modelled gene-environment correlation. The sample comprised >28,100 children in extended-family units drawn from the Norwegian Mother, Father and Child Cohort Study (MoBa). Mothers reported children's emotional and behavioural symptoms. Parents' income and educational attainment were obtained through linkage to administrative register data. Bivariate moderation Multiple-Children-of-Twins-and-Siblings (MCoTS) models were used to analyse relationships between offspring outcomes (emotional and behavioural symptom scores) and parental socioeconomic moderators (income rank and educational attainment). The aetiology of child emotional symptoms was moderated by maternal and paternal educational attainment. Shared environmental influences on child emotional symptoms were greater at lower levels of parents' education. The aetiology of child behavioural symptoms was moderated by maternal, but not paternal, socioeconomic factors. Genetic factors shared between maternal income and child behavioural symptoms were greater in families with lower levels maternal income. Nonshared environmental influences on child behavioural symptoms were greater in families with higher maternal income and education. Parental socioeconomic indicators moderated familial influences and nonshared environmental influences on child emotional and behavioural outcomes. Maternal SES and child mental health share aetiological overlap such that shared genetic influence was greater at the lower end of the socioeconomic distribution. Our findings collectively highlight the role that family socioeconomic factors play in shaping the origins of child emotional and behavioural problems.

Potential barriers to early diagnosis of autism in Turkey: an evaluative study

ABSTRACT Our objective was to evaluate pathways between initial concerns of parents regarding atypical development of their children and autism spectrum disorder (ASD) diagnosis in Turkey. The study included 199 children aged 18–97 months and diagnosed with ASD. The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were used along with information obtained from parents and direct observation of the child. The Childhood Autism Rating Scale (CARS) was used as a diagnostic tool. A 45-minute semi-structured interview was conducted with parents to evaluate the time until their child was diagnosed with ASD. A period longer than 1 year (mean: 13.69 ± 10.80 months) had passed from the first concern of parents until their children were diagnosed with ASD. Further, 53.8% of parents consulted a healthcare professional a few months after their initial concern and 46.2% did not for a longer time (9.34 ± 8.36 months). Maternal education level, socioeconomic status, and higher Autism Behavior Checklist (ABC) relating subscale scores predicted an earlier age for a diagnosis of ASD, while higher ABC language subscale scores predicted ASD diagnosis at older ages. Based on our results, it appears that factors such as spoken language and socioeconomic level may be related to significant delays in ASD diagnoses in Turkey.

Impact of maternal education on the growth of children in a patriarchy

Aim: To assess the association of father’s education and occupation with children growth measured by height-for-age z-scores and BMI-for-age z-scores in a patriarchal culture where father’s social position is considered more important than mother’s social position. Sample and methods: The present cross-sectional study consists of 387 school-going girls aged 9-14 years residing in Matigara, Siliguri sub-division of Darjeeling district, West Bengal, India. Information on age, mother’s education, father’s education, ethnic affiliation, mother’s occupation, father’s occupation, house type, household monthly income and family size were recorded. Associations between variables were assessed using Spearman correlation, St. Nicolas house analysis (SNHA), and one-way analysis of variance (ANOVA) with box plots. Results: The hypothesis that in a patriarchy paternal socio-economic status (SES) influences children growth more than maternal SES was not supported. The observed correlation between mother education and measure of growth (BAZ and HAZ) was, 0.15 and 0.13, respectively. SNHA showed direct connection between HAZ of girls and mother education. Further, using ANOVA significant difference in the HAZ of adolescents was observed between least educated mothers and moderately educated mothers (F = 6.593; p &lt; 0.01). No such difference between the maternal education levels was observed for BAZ. Conclusion: Maternal education is an important factor influencing children linear growth even in a patriarchy. The association was independent of nutrition. Common explanations are functional literacy, decision making, access to information and health infrastructure, and less domestic violence. Mother’s education may influence perceived future prospects of the daughters, and could be an important stimulus for growth.

Maternal risk factors for preterm birth in Taiwan, a nationwide population-based cohort study

The rate of preterm birth is increasing globally. It causes significant short-term and long-term health care burdens. A comprehensive recognition of the risk factors related to preterm births is important in the prevention of preterm birth. Our study is to investigate the incidence and maternal risk factors of preterm birth from a nationwide population-based perspective. This is a retrospective cohort study. All live births from 2004 to 2014 in Taiwan enrolled. The main data source was Taiwan's Birth Certificate Application (BCA) database. The BCA database was linked with the National Health Insurance Research Database (NHIRD) to establish any links between information on newborns and maternal underlying disease. A total of 1,385,979 births were included in the analysis. The incidence of preterm birth increased gradually in Taiwan from 8.85% in 2004 to 10.73% in 2014. Maternal age, socioeconomic status, maternal allergy and autoimmune diseases, gynecological diseases, and pregnancy-related complications were significant risk factors for preterm birth. The overall incidence of preterm births has gradually increased in Taiwan. Maternal age, socioeconomic status, certain underlying diseases, and pregnancy-related complications were risk factors for preterm birth.

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.