Health Status Of Mothers Research Articles

HUBUNGAN KETERATURAN PEMERIKSAAN ANC TERHADAP KEJADIAN ANEMIA DI WILAYAH KERJA PUSKESMAS TURIKALE KECAMATAN TURIKALE KABUPATEN MAROS

Regular pregnancy checks will determine the mother's health status during pregnancy because basically the cause of Fe deficiency anemia in pregnant women is caused by two factors, namely direct and indirect factors. Meanwhile, factors that do not directly influence a person's Hb levels by influencing the availability of Fe in food include the low economy.The aim of this research is to determine the relationship between the regularity of ANC examinations and the incidence of anemia in the Turikale Community Health Center Working Area, Turikale District, Maros Regency. The type and research method used is the Cross Sectional Study method. In this study, the samples taken were 36 third trimester pregnant women who had their pregnancies checked in the Turikale Community Health Center Working Area, Maros Regency, using purposive sampling. The research results showed that 29 people (80.6%) regularly made ANC visits and 7 people (19.4%) did not regularly. Six respondents (16.7%) experienced anemia and 30 respondents (83.3%) did not experience anemia. There is a relationship between the regularity of ANC visits and the incidence of anemia with a value of ρ=0.004<from α=0.05, this means that Ho is rejected and Ha is accepted. It is hoped that it can increase monitoring and screening of pregnant women who experience high levels of anemia through home visits, making class activities more effective for pregnant women and empowering families, especially husbands or parents, to be motivated to invite pregnant women to have their pregnancies checked regularly. The husband or closest family member can be given an understanding of the dangers and efforts to prevent anemia in pregnant women

The Contribution of Forgotten Foods for Supporting Food Security in Gunungkidul, Yogyakarta – Indonesia

Background: Gunungkidul, one of the districts in the special region of Yogyakarta – Indonesia, was reported to have a significant number of food-insecure villages. However, it conserved various forgotten protein-source food as a regional heritage delicacy. This study aims to evaluate the contribution of forgotten foods (edible insects, aquatic animals, indigenous plants) to support food security among poor households in Gunungkidul district, Indonesia. Methods: Food security status was evaluated according to the method by Maxwell. The characteristics of socio-economic households, food consumption behaviour, nutritional status of children under five, and health status of mothers and children among the targets were also assessed through an interview using a structured coded questionnaire. The food consumption pattern was analyzed by using food recall 2 x 24 hours and a semi food frequency questionnaire. This study involved 240 poor households below the poverty line, mainly farmers (60%). Results: This study revealed that 48% of households were food-insecure, 39% were food-vulnerable, 8% were less food-secure, and 5% were food-secure. Aquatic animals and edible insects contributed as many as 22 making up for 1% of daily protein needs, respectively. A preference shifting on those forgotten foods seems to become one barrier to this contribution. Conclusion: The forgotten foods might be an alternative to a future challenge in supporting human well-being. In this case, aquatic animals and edible insects are considered as future protein sources.

Anaemia prevention among pregnant women: Views and experiences of pregnant women and antenatal care providers in Accra, Ghana

Background and ObjectiveAnaemia among pregnant women is a public health challenge in Ghana. Although there isa national programme of routine iron-folic acid (IFA) supplementation, coverage issuboptimal. The current study explored experiences and perceptions of anaemiaprevention, and IFA use among pregnant women and antenatal care providers at twohospitals in Accra, Ghana, for enhancing the supplementation programme.MethodsUtilizing a qualitative approach, 6 focus group discussions with 48 purposively selectedpregnant women, and 10 in-depth interviews with care providers in two hospitals wereconducted. Interviews were transcribed verbatim. Using both deductive and inductiveapproaches, priori themes that informed the design of the interview guides, and emergingcodes from transcripts were used in data analysis.ResultsIn both hospitals, pregnant women reported awareness of anaemia and identified poorquality diets and failure to take IFA as the predominant causes. Regular IFAsupplementation, and consumption of fruits, vegetables, and animal-source foods wereindicated as the main anaemia remedies by the pregnant women. Turkey berry, beetroot,and hibiscus flower were also reported as therapeutic remedies for anaemia. IFA use waslinked with improved appetite, haemoglobin, and health status of mothers and their fetus.Both providers and pregnant women indicated that IFA is freely accessible throughgovernment facilities but may also be purchased. IFA supplements are recommended to betaken daily but three times for treatment; however, non-adherence to the recommendedfrequency was reported. This was attributed to adverse reactions including nausea andvomiting, unanticipated cost of increased appetite, forgetfulness to take IFA,misperceptions about adverse effects of IFA, transportation cost to access IFA, and longwaiting time at hospitals. Community-level focused antenatal care, follow-up visits, andphone calls were reported by providers as strategies to improve IFA uptake. Communitysensitization, enhanced access to IFA, and participatory approach to ANC services weresuggested by pregnant women as strategies for improving IFA uptake.ConclusionsFood insecurity and misperceptions about IFA should be addressed as part of efforts toaddress low IFA adherence and high maternal and child anaemia rates in Ghana.

Model development for anemia prediction in pregnancy

BackgroundThe number of pregnant women who suffer from anemia is still high. Anemia has an impact on the health status of mothers, fetuses, and newborns. This paper aims to develop an anemia risk prediction model for pregnant women in Indonesia. MethodsThe data was obtained from the Indonesian basic health research database years 2013 and 2018. A bivariate method the user to select which variables are significantly affecting anemia in pregnant women. The result was then analyzed using the multivariate for model development and the data was then plotted into a receiver operator characteristic (ROC) to illustrate the relationship between clinical sensitivity and specificity. ResultsThe variables that significantly to the anemia risk status of pregnant women are iron supplement during pregnancy (p = 0.003) and MUAC (p = 0.001) from 2013 data. After analyzing using multivariate, only MUAC and iron supplement during pregnancy could be included in the prediction model since the p-value is less than 0.05. The ROC value is 60.7 % with a sensitivity of 87.8 % and a specificity of 75.7 % for the 2013 data and we got the same ROC score is 60.7 % for the 2018 data with a sensitivity of 94.3 % and a specificity of 90 %. ConclusionResults suggest that the anemia risk prediction model developed based on data from pregnant women in 2013 and 2018 consisted of 2 variables, namely iron consumption and mid-upper arm circumference.

The Effect of Pregnancy Class on Mothers’ Knowledge Regarding Pregnancy

A mother's lack of knowledge about pregnancy will affect the mother's health status. So promotional efforts, one of which is holding classes for pregnant women, are really needed. The aim of this research was to determine the effect of pregnant pregnancy class on mothers' knowledge about pregnancy. The design of this study is quasy experimental. The population is all pregnant women who visited Mekarsari Health Centre during the study period. 15 pregnant women were recruited as the sample purposively with a gestational age between 20-32 weeks. The results found that pregnant women's knowledge is significantly higher than before the implementation of the pregnancy class. The conclusion of the research results is that there is a difference in the level of knowledge of pregnant women about pregnancy before and after carrying out classes for pregnant women at the Mekarsari Health Center, Tambun Selatan District, so it is recommended that the development and monitoring of the implementation of maternal classes be better across programs and across sectors and it is hoped that midwives can carry out the classes.

Body Care as an Effort to Improve Beauty and Health for Post Partum Mothers in Lamongan Regency, East Java, Indonesia

Pregnancy, childbirth and breastfeeding are natural and physiological processes for every woman who plays the role of a mother. The end of this quite long process is the birth of a baby which the parents have been waiting for. After the baby is born with the placenta, it will be the peak of adaptation for a mother and her baby. The mother will enter the postpartum and breastfeeding period where the mother will assume her new role. Some of these discomforts will bother the mother and cause increased morbidity in the mother. The World Health Organization (WHO) recommends that health care during the postpartum period can be started 24 hours after giving birth or when the mother is in a physiological postpartum state. This treatment can be carried out by competent personnel such as doctors, midwives or nurses. This health care is an effort to improve the level of health as a mother in general and during the postpartum period and breastfeeding in particular. From this adaptation process you will find some discomfort. This can be overcome with postpartum care. The research method used is descriptive quantitative. Using the total population, from the cross tabulation results, 65.7% of postpartum mothers who underwent postpartum care were in a healthy condition during the postpartum period (42 days). These results show that there is a tendency for mothers who undergo postpartum care to have a healthy body condition. From this, it becomes a reference that postpartum care is very important for postpartum mothers to be able to improve the mother's health status during the postpartum period and beyond

Awareness of sudden infant death syndrome and its associated risk factors among Saudi mothers attending well-baby clinics at PHC, PSMMC, Riyadh, Saudi Arabia: A cross-sectional study.

Sudden infant death syndrome (SIDS) is a leading cause of infant mortality all over the world. Mortality due to SIDS can be averted by educating families and caretakers about safe practices for putting infants to sleep. However, the knowledge, attitude, and practices of mothers while putting the infant to sleep is a gray areas in literature. The objectives of the study were to measure the knowledge and awareness about SIDS and its associated risk factors practiced among Saudi mothers attending well-baby clinics in Saudi Arabia to develop appropriate educational program-based interventions for safe practices of infant care. This cross-sectional study was carried out among 385 mothers attending well-baby clinics of primary health care (PHC) and prince sultan military medical city (PSMMC) in Riyadh Saudi Arabia. Information was captured on sociodemographic characteristics, the health status of mothers and infants, knowledge, attitude, and practice followed by mothers while putting infants to sleep. From a total number of 385 responses, 350 participants were eventually included in the final sample due to the incompletion of the questionnaire of 350 mothers; only 26% (n = 93) mothers had heard of SIDS. However, 259 mothers were willing to attend the awareness session. Only 94 mothers had knowledge as well as practicing the correct behavior of putting the infant to sleep on the back referred to as "good behavior concordant pairs." Similarly, other good practices include not co-sharing a bed with the infant, removing pillows, blankets, and other wedged objects, using a pacifier, breastfeeding the infant during sleep, not using multiple quilts, not covering the infant's head with a quilt, not using a head cap. The number of good behavior concordant pairs (in green) were 124, 38, 56, 98, 18, 117, and 68 respectively. The rate of knowledge and practice for good behavior regarding SIDS was low among Saudi mothers in Riyadh Saudi Arabia. SIDS-related deaths can be averted by improving the understanding of SIDS risk reduction practices among mothers by using health promotion strategies.

Grouping Analysis of Maternal and Child Health Degree in Indonesia, Using Structural Equation Modeling Partial Least Square-Prediction Oriented Segmentation (Sem Pls-Pos)

One of Indonesia's development goals in 2020-2024 is to form quality and competitive human resources. One of the efforts to achieve this goal is to improve the quality of maternal and child health. However, the issue of Maternal and Child Health (MCH) is still a challenge for the Indonesian health system. This study aims to determine the modeling and to obtain provincial groupings based on the degree of maternal and child health in Indonesia. The method used is Structural Equation Modeling Partial Least Square-Prediction Oriented Segmentation (SEM PLS-POS). The results of the PLS SEM analysis showed that the environmental variables and health services had a significant effect on the health status of mothers and children with an R2 value of 48.8%. The grouping of provinces based on the degree of maternal and child health in Indonesia using PLS-POS produces 3 segment classes. Segment 1 consists of 11 provinces, segment 2 consists of 13 provinces and segment 3 consists of 10 provinces with a large influence between different latent variables.

The prevalence and risk factors associated with Iron, vitamin B12 and folate deficiencies in pregnant women: A cross-sectional study in Mbeya, Tanzania.

Maternal nutrition is an important forecaster of infant's and mother's health status in most developing countries. This study aimed at assessing the prevalence and associated risk factors of iron, vitamin B12, and folate deficiencies among pregnant women in Mbeya Tanzania. A cross-sectional study using a cluster randomized sampling was conducted among 420 pregnant women. A structured questionnaire was used to collect socio-demographic and dietary assessment. Body iron store was assessed using serum ferritin measured by immunoturbidimetric assays using a Roche Cobas 400+ biochemistry analyzer. Serum folate was measured by folate microbiological assay, while serum vitamin B12 was measured by immunochemiluminescence assay using a Roche Cobas e411 immunoassay analyzer. Multivariate analysis was performed using Poisson regression. The prevalence of iron, folate, and vitamin B12 deficiencies among pregnant women in Mbeya was 37.8%, 24.0%, and 9.7% respectively. Higher odds of iron deficiency were seen in pregnant women aged 20-24 years older [Adjusted OR = 1.20 (95%CI 1.03, 1.35)], not employed [Adjusted OR = 3.0(95%CI 1.03-1.77)] and, not received iron/folic acid supplementation [Adjusted OR = 1.11 (95%CI 1.003-1.23)]. Pregnant women with highest and middle socio-economic statuses had lower odds of vitamin B12 deficiency [Adjusted OR = 0.83 (95%CI 0.76-0.92)] and [Adjusted OR = 0.89 (95%CI 0.81-0.98)] respectively. Pregnant women who were not employed, not received iron and folic acid supplement during pregnancy and, not consumed edible vegetable cooking oil had significant higher odds of serum folate deficiency [Adjusted OR = 3.0 (95%CI 1.58-5.68)], [Adjusted OR = 1.53 (95%CI 1.21-1.93)] and, [Adjusted OR = 2.77 (1.03-7.44)] respectively. This study confirms that iron, folate and vitamin B12 deficiencies are still a major challenge among pregnant women in Tanzania. We recommend for public health interventions for the provision of vitamin B12 along with iron and folic acid supplementations, especially in pregnant women belong to low socio-economic status and limited knowledge of healthy diet.

Effect estimate of time-varying social support and trust on the physical and mental health of mothers at 2.5 years postpartum: The Japan Environment and Children's Study (JECS).

Many epidemiological studies have reported the association between various social factors and health status in mothers during and after pregnancy. However, little is known about their joint and longitudinal impact. We therefore examined the association of lack of social support and trust during pregnancy and at 2.5 years postpartum with health status in mothers. To adequately address time-varying exposure, marginal structural models were fitted to a pseudopopulation constructed by inverse probability weighting. The model included records of 90,071 mothers participating in the Japan Environment and Children's Study. Social support and trust were measured using a 9-item questionnaire (Q1-9). Mental and physical health were measured using Mental and Physical Component Summary scores from the 8-item Short-Form Health Survey. For the Mental Component Summary, the magnitude of the effect estimate was largest when participants lacked close friends/neighbors (Q4) at only 2.5 years postpartum (= -6.23), followed by a lack in emotional support (Q2) at the same time point (= -4.94). For the Physical Component Summary, effect estimates were negligible. The magnitude of the effect estimates of lack of social support and trust tended to be larger when there was a lack at only 2.5 years postpartum than at both time points. These findings suggest that, after childbirth, a loss in social support, particularly in a concrete or instrumental aspect, carries high risk, especially for mental health. Our results highlight the importance of supporting mothers for more than a few years after pregnancy.

Prenatal Environmental Stressors and DNA Methylation Levels in Placenta and Peripheral Tissues of Mothers and Neonates Evaluated by Applying Artificial Neural Networks.

Exposure to environmental stressors during pregnancy plays an important role in influencing subsequent susceptibility to certain chronic diseases through the modulation of epigenetic mechanisms, including DNA methylation. Our aim was to explore the connections between environmental exposures during gestation with DNA methylation of placental cells, maternal and neonatal buccal cells by applying artificial neural networks (ANNs). A total of 28 mother-infant pairs were enrolled. Data on gestational exposure to adverse environmental factors and on mother health status were collected through the administration of a questionnaire. DNA methylation analyses at both gene-specific and global level were analyzed in placentas, maternal and neonatal buccal cells. In the placenta, the concentrations of various metals and dioxins were also analyzed. Analysis of ANNs revealed that suboptimal birth weight is associated with placental H19 methylation, maternal stress during pregnancy with methylation levels of NR3C1 and BDNF in placentas and mother's buccal DNA, respectively, and exposure to air pollutants with maternal MGMT methylation. Associations were also observed between placental concentrations of lead, chromium, cadmium and mercury with methylation levels of OXTR in placentas, HSD11B2 in maternal buccal cells and placentas, MECP2 in neonatal buccal cells, and MTHFR in maternal buccal cells. Furthermore, dioxin concentrations were associated with placental RELN, neonatal HSD11B2 and maternal H19 gene methylation levels. Current results suggest that exposure of pregnant women to environmental stressors during pregnancy could induce aberrant methylation levels in genes linked to several pathways important for embryogenesis in both the placenta, potentially affecting foetal development, and in the peripheral tissues of mothers and infants, potentially providing peripheral biomarkers of environmental exposure.

Maternal determinants for 4 Ds in children registered under Rashtriya Bal Swasthya Karyakram program at an urban health centre of Ahmedabad

Background: Maternal determinants influence the outcome of pregnancy and child’s health in early years. Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures. Methods: Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker. Results: Relevant information could be gathered from 96 mothers. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p<0.0001). Out of 102 cases under study, minimum recommended 4 ANC visits were not taken by 17 (17.7%) mothers. Also, 13 (13.5%) did not take IFA supplementation. Poor health status during pregnancy, was significantly associated for deficiency disorders of child in later life (p<0.04). Conclusions: Maternal age at pregnancy, health status of mother, ANC care (number of ANC visits, IFA supplementation), health seeking behaviour, birth weight and birth order of child were major determinants of 4Ds.

Socialization of Lactation Massage to Postpartum Mother

Indonesia's health profile in 2016 shows that the coverage of infants who are breastfed for up to six months is only 29.5%. This figure is still far from the national target of 80%. Based on data from the profile of the Bali Provincial Health Office, the coverage rate of exclusive breastfeeding in Bali is 72.8%. By district or city, exclusive breastfeeding coverage in Badung Regency is 70.29%, Buleleng 61.95%, Gianyar is 80.02%, Jembrana is 84.7%, Karangasem is 69.68%. From these data, it can be seen that Gianyar Regency and Jembrana Regency have succeeded in achieving the national target (Bali Provincial Health Office, 2016). Meanwhile, the percentage of babies who received exclusive breastfeeding specifically at the age of 0 to 6 months in Bali Province was 30.1% (Kemenkes, 2016)
 The role of midwives in carrying out their profession must be in accordance with the existing midwifery concept in accordance with the results of the 2011 IBI National Work Meeting. One of the roles of the midwife during the postpartum period is to make home visits at least 3 times to monitor the condition of the mother and baby after giving birth and ensure that the baby is exclusively breastfed. In addition to home visits, the role of the midwife is also to provide counseling, counseling and socialization regarding proper breast care through lactation massage (Maternal and Child Health, 2016).
 The target of the program that will be carried out is to improve the health of mothers and babies by providing socialization about lactation massage to facilitate milk production. The output of the resulting program is an increase in the health status of mothers and babies.

Maternal social capital, health status and wellbeing of mothers of children under five years in Ibadan, Nigeria.

SummaryIntroductionThis study investigated the influence maternal social capital has on the health and wellbeing of mothers of under-five children in a semi-urban local government area in Ibadan, Nigeria.MethodsA descriptive cross-sectional study that utilised a three-stage sampling technique was adopted to select 385 respondents from 4 primary health care centres in Ibadan, Nigeria. Data collection was done using a semi-structured questionnaire to assess mothers’ social capital, wellbeing and body Mass Index (BMI). Data analysis was done using descriptive and inferential statistics at the significant level of P < 0.05.ResultsBenefits derived from participating in social groups such as: useful health information (p = 0.005; p = 0.000) and child care support (p = 0.003; p = 0.002) were significantly associated with wellbeing and health status of mothers respectively.ConclusionsMothers should be encouraged to engage in networks that are of healthful benefits to ensure effective knowledge sharing in sustaining promotion of health and wellbeing among mothers of under-five children.

Maternal attachment and mental health status in mothers who have babies with infantile colic

PurposeThe aim of this study was to determine maternal attachment and mental health status in mothers of babies with infantile colic. DesignCross-sectional online survey. SettingThe study was conducted on messaging and social media platforms, and groups related to mothers and babies. Participants380 mothers, 107 of whom had babies with infantile colic and 273 of whom had healthy babies, participated in the study. Measurement Tools and FindingsA Personal Information Form, the Maternal Attachment Inventory, and the Depression, Anxiety and Stress Scale were used to collect data. No statistically significant relationship was found between infantile colic status and maternal attachment. The depression, anxiety and stress scores of the mothers who had babies with infantile colic were significantly higher compared to the mothers with healthy babies (p<0.05). Additionally, as the depression scores of the mothers increased, their maternal attachment levels decreased (p <0.05). Key ConclusionsMaternal depression, anxiety and stress make it difficult for mothers to provide care for their babies. Therefore, health professionals should screen mothers who have babies with infantile colic in the postpartum period in terms of mental health. Besides, the mothers should be provided with support to assist them in coping with their Babies’ colic. Implications for PracticeHealth professionals should be aware that infantile colic negatively affects the mental health of mothers and increases the frequency of follow-ups of these mothers in the postpartum period. More research is needed to examine the effects of infantile colic on maternal attachment.

Postpartum Health Care Seeking Behaviour among the Rural Women in Bangladesh

Introduction: Pregnancy and childbirth is an important event in the life cycle of women and their health during this period is very much vital for the mother and children. Maternal mortality ratio (MMR) of a country is an important indicator of the overall health status of mother. Objectives: To assess the health care seeking behaviour of postnatal women in rural Bangladesh. Materials and Methods: This cross sectional study was conducted at Chaturia in Dhamrai upazilla of Dhaka district from January 2019 to March 2019 among purposively selected 196 rural women of reproductive age who had at least one living child. Data were collected by face-to-face interview using pretested questionnaire. Results: Among 196 respondents average monthly family income was 12561 Taka with SD of 10462 taka. Majority of them were housewives and about two-third (64.8%) were educated above secondary level. 70.9% respondents had their delivery of last child in a government health care center and 37.8% deliveries were conducted by nurses which was followed by government doctors (36.2%). Majority (62.2%) had their health checkup within 42 days, 59.2% of them had checkup for three or more times and the checkup were done by government doctors (60.2%). 47.1% of the respondents experienced high grade fever as postpartum complication. Statistically significant association (p&lt;0.05) were revealed between age group of the respondents with health personnel conducted deliveries and also between educational level of the respondents with place of delivery of last child. Conclusion: Awareness, motivation and infrastructural development play a vital role in utilizing the government healthcare services by the postnatal women in rural Bangladesh. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 80-83

KNOWLEDGE ON PRECONCEPTION CARE AMONG BACHELOR LEVEL NURSING STUDENTS OF SELECTED CAMPUSES IN BAGMATI PROVINCE

Background: Preconception care is the provision of biomedical, behavioural and social health interventions to women and couples before pregnancy to improve the health status of mother, new-born and child. There is growing evidence that preconception care may have an important role in preventing short and long-term adverse health consequences for women and their offspring. So this study was conducted to assess knowledge on preconception care among bachelor-level nursing students. Methods: A descriptive cross-sectional design with a purposive sampling technique was used to select 129 students from Constituents and affiliated Nursing campuses of Tribhuvan University in Bagmati Province. Data were collected over one month from 1st September to 27th September 2020. Knowledge on preconception care was evaluated through self-administered questionnaires. Analysis was done by using descriptive statistical tests. Results: Among 129 respondents, 17.8% of respondents had adequate and 81.4% had a moderate level of knowledge on preconception care. The respondents had adequate levels of knowledge on teratogens and environmental toxins and inadequate on some of the very important issues such as proper time for preconception care, birth spacing, hygiene, and vaccines contraindicated during pregnancy. Conclusions: Based on the findings, most of the respondents had a moderate level of knowledge but as a nurse to provide holistic care to the client and future mother they have to have an adequate level of knowledge to prevent adverse consequences of maternal and child health. Therefore, there seems to be a strong need to develop a simple guideline of preconception care and incorporate it into the nursing curriculum.

Determinants of maternal health four weeks after delivery: cross-sectional findings from the KUNO-kids health study

BackgroundThe aim of this study was to examine the interaction of a multitude of socio-economic, lifestyle, environmental, psychosocial and birth related determinants and their effect on maternal health four weeks after delivery.MethodsWe used data from a German birth cohort study, the KUNO-Kids health study. Social determinants, as well as the self-rated maternal health and the physical and mental health status of mothers (indicated by means of the SF-12-questionnaire) were assessed through standardized questionnaires and personal interviews right after delivery and four weeks later. Linear regression models were calculated to determine the relationship between influencing factors and health outcomes.Results1428 women were included in the analysis. Maternal self-rated health showed significant positive associations with breastfeeding (B (regression coefficient) 2.67; 0.86–4.48 (95% Confidence interval)) and estimating one’s child as rather healthy (B 0.27; 0.19–0.34) and negative associations with social and emotional strains (B -3.50; -5.11- -1.88), obesity (B -2.56; -4.69- -0.42), having experienced a C-section (B -1.73; -3.23- -0.23), a positive history of somatic diseases (B -2.14; -3.53- -0.74), parental stress (B -0.39; -0.66- -0.11) and education of more than ten years (B -2.42; -3.95- -0.90).Maternal physical health status showed significant negative associations with age (B -0.13; -0.25- -0.01), employment before maternity leave (B -1.90; -3.59- -0.21), social and emotional strains (B -1.50; -2.67- -0.34), parental stress (B -0.28; -0.45- -0.12), C-section (B -4.06; -5.12- -2.99), having the first child (B -2.03; -3.09- -0.97) and a history of somatic diseases (B -2.00; -2.99- -1.01).Maternal mental health status showed significant positive associations with education of more than 10 years (B 2.27; 0.98–3.56) and a high level of social support (B 1.20; 0.06–2.34), while social and emotional strains (B -4.16; -5.48- -2.84) and parental stress (B -0.70; -0.92- -0.47) were negatively associated.ConclusionsWe identified important protective factors for maternal health four weeks after delivery, such as a high level of social support. However, parental stress and social and emotional strains in particular seem to have a negative influence on maternal health. These findings have public health relevance.

Estimation of the Distribution of Duration of Breastfeeding from Cross-Sectional Data: Some Methodological Issue

Background: Duration of breastfeeding is an important health indicator of mother and child. There are various indirect epidemiological methods available to estimate the duration of breastfeeding from cross sectional data. Objective: To estimate the distribution of duration of breastfeeding at national level cross sectional data and compare various available technique. The impact of the sampling frame (ascertain of the individual understudy) is also evaluated. Method: National Family Health Survey (NFHS-IV) data is used. Duration of breastfeeding of only those children who were born before 60 months from survey date were included in the study. The technique of Current Status Data, Life Table Analysis, and Kaplan Meier (KM) estimator is applied to assess the distribution of duration of breastfeeding. Result: The mean estimate is 32.84, 33.14 and 33.64 months by Kaplan Maier Estimator, Current Status Data and Life Table Analysis respectively. The Current Status and Life Table method are better than Kaplan Meier Estimator as it is doesn’t based on recall data and heaping present in the data. Conclusion: One must be very cautions while estimating the various epidemiological parameters from cross section data set. The assumptions of the methodology as per data available should be evaluate. If such data is not available, the available methodology may be modified. Regression analysis based on Current Status data technique may be used to assess the impact of various clinical and epidemiological factors (such as nutrition of mother, health status of mother etc.) on duration of breastfeeding

Factors affecting psychosocial development of very low birth weight infants at 18 and 36 months of age.

To identify relationships between neonatal factors including conditions and treatments, nurturing environment, and psychosocial development of children born at very low birth weight (VLBW). In this longitudinal study, the medical records of 113 VLBW infants were examined, and the children were then followed up at 18 and 36 months of age. Their developmental quotient (DQ) was assessed using the Kyoto Scale of Psychological Development (KSPD), and their parents were asked about their own health, financial situation, education, and family support. Pearson's correlation and stepwise multiple regression analyses were used to explore relationships between DQ, potentially significant predictors on the KSPD, and nurturing environment. DQ at 18 months was associated with the following neonatal factors: mechanical ventilation days (β = -.241, p = .020), Apgar score at 5 min (β = .278, p = .005), periventricular leukomalacia (β = -.218, p = .006), and treatment for retinopathy of prematurity (β = -.171, p = .048) (adjusted R2 = .32). DQ at 36 months was associated with the following neonatal and parenting factors: mechanical ventilation days (β = -.354, p < .001), periventricular leukomalacia (β = -.207, p = .009), sex (β = -.199, p = .011), mother's educational background (β = -.304, p < .001), mother's health status (β = -.159, p = .042) (adjusted R2 = .35). These findings suggest that in addition to neonatal clinical parameters including conditions and treatments, the nurturing environment after discharge from the neonatal intensive care unit influences the psychosocial development of VLBW infants.