Older Mothers Research Articles

Time trends in maternal hypertensive disorder incidence in Brazil, Russian Federation, India, China, and South Africa (BRICS): an age-period-cohort analysis for the GBD 2021

ObjectivesMaternal hypertensive disorder (MHD) is a leading cause of significant maternal and fetal mortality and morbidity. The BRICS nations are crucial in the global MHD landscape, given their large populations and varied healthcare infrastructures. This investigation evaluates the incidence trends of MHD in BRICS countries from 1992 to 2021.Study design and methodsData on the number, all-age rate, age-standardized rate (ASR), and the relative change of MHD incidence from this study were sourced from the Global Burden of Disease (GBD) 2021 public dataset to investigate temporal trends in MHD incidence over three decades globally and in BRICS countries. The age-period-cohort (APC) model was used to estimate net drift, local drift, age-specific curves, and period (cohort) relative risks.ResultsA 15.87% increase in global MHD cases, alongside a 13.40% decrease in age-standardized incidence rates from 1992 to 2021. MHD incidence rates are declining across various BRICS age groups, except in China and Russian Federation, where most groups exhibit increasing trends. Annual net drift in MHD incidence ranges from − 4.25% in India to 2.38% in China. A shift in the age distribution of MHD cases from younger to older within the childbearing age range is observed in all BRICS nations. Countries exhibit similar age-effect patterns, with decreasing risk with increasing age, and varying period and cohort effects, indicative of differential control measures and temporal incidence trends.ConclusionsGlobal and BRICS-specific reductions in MHD incidence vary in magnitude. Customized preventive strategies, leveraging existing resources, are advisable for BRICS nations to address pregnancy complications. Enhancing primary healthcare and maternal care quality, particularly for older mothers, is imperative.

Parental Age and Severity of Non-Syndromic Orofacial Clefts: Relationship with De Novo Mutations

Background: This study investigates the relationship between paternal and maternal age, and the severity of orofacial clefts and the presence of de novo mutations in children. Methods: This was a retrospective study of individuals who were diagnosed with non-syndromic cleft lip and/or palate (CL/P) and their unaffected parents, from 2012 to 2019. We obtained data from the AfriCRAN project database for Nigerians with non-syndromic orofacial clefts. These individuals were recruited at the Oral and Maxillofacial Surgery Clinic, Lagos University Teaching Hospital, Lagos. Results: There was no statistically significant association between type of CL ± P and parental age in young fathers (p = 0.93). When older fathers were considered, the percentage of complete (more severe) CL ± P cases increased, especially when they were married to older mothers, and this was statistically significant (p = 0.036). In older fathers, the risk of CL ± P in their offspring was increased (OR: 2.66, CI: 1.04-6.80), and there was also an increased risk of developing right-sided CL ± P (OR: 1.61, CI: 1.0-2.59). There was a reduced risk of isolated clefts of the soft palate in younger fathers (OR: 0.36, CI: 0.07–1.71), but the risk increased when considering complete types (more severe) of isolated clefts of the hard and soft palates (OR: 1.63, CI: 0.7–1.7). There was an increase in de novo mutation in children as the difference between paternal and maternal age increased. Conclusion: The study showed that a higher risk of CL ± P and de novo mutations in children is associated with increased parental age.

Influence of Household Socio-Economic, Demographic, And Cultural Factors on Women's Access to Maternal Healthcare in Malindi Sub County, Kilifi County, Kenya

Globally, maternal healthcare access remains a critical concern due to significant disparities, particularly in developing countries where access rates are notably lower. The Sustainable Development Goals underscore the importance of prioritizing maternal health, urging nations to improve access to maternal healthcare services. However, various factors hinder full access to such services. This study investigated the influence of social and economic factors on household access to maternal healthcare in Malindi Sub County, Kilifi County. Specifically, it examined the impact of income levels, literacy rates, parental age, and religious beliefs. The study, grounded in the Behavioral Model of Healthcare Service Utilization, Maternal Morbidity Measurement (MMM), and the Three Delay Theory, employed a descriptive survey design approach. A sample size of 382 respondents was determined using the Krejcie and Morgan’s (1970) formula from a population of 73,547 households. Stratified sampling was employed to divide the sub-county into five strata based on wards, selecting households with mothers accessing maternal health services using purposive sampling. Additionally, twenty respondents were purposively chosen for key informant interviews. Because the dependent variable in the questionnaire was binary (access to maternal healthcare was either yes or no), the study used binomial logistic regression modeling to ascertain the influence of income levels, literacy levels, parental age and religious beliefs on the access to maternal healthcare. Income levels, with a coefficient of 2.236 (p-value = 0.007), literacy levels, with a coefficient of 1.981 (p-value = 0.002), and religious beliefs, with a coefficient of 1.004 (p-value = 0.037), were identified as significant factors positively influencing access to maternal healthcare. Conversely, parental age demonstrated a significant negative impact on access, with a coefficient of -1.262 (p-value = 0.004). The study concludes that socioeconomic status, education, and religious beliefs significantly influence maternal healthcare access, with a particular concern regarding diminished access as parental age increases. Consequently, this research emphasizes the critical need for targeted interventions to alleviate these disparities, recommending economic empowerment for women with lower income levels, health literacy education initiatives for vulnerable populations, and a multimodal approach to address cultural barriers and support both younger and older mothers in accessing healthcare services.

ANÁLISE DAS REPERCUSSÕES FETAIS, NEONATAIS E OBSTÉTRICAS RELACIONADAS A IDADE MATERNA AVANÇADA E PRECOCE

In Brazil, pregnancy at extreme ages, whether in adolescence or advanced age, poses significant challenges to maternal and neonatal health. In a country where one in every seven babies is born to adolescent mothers, and there has been a 70% increase in pregnancies among women aged 35 to 38 over the last two decades, it becomes essential to understand the obstetric and neonatal repercussions of these pregnancies. This study aimed to analyze the fetal, neonatal, and obstetric complications associated with early and advanced maternal age. It is an epidemiological study with data collected from TabNet of DataSUS, covering the period from 1996 to 2020. The variations found included maternal and fetal deaths, as well as sociodemographic characteristics of the mothers. The results show that adolescent mothers have a higher risk of newborns with low birth weight and fetal mortality, especially in the Northeast region. On the other hand, older mothers show lower fetal mortality but a higher prevalence of obstetric complications, particularly in the Southeast region. The research highlights the need for public policies focused on reducing risks in pregnancies with greater vulnerability and on training health professionals for better monitoring.

Trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone

BackgroundSierra Leone has improved child health outcomes in recent decades. However, diarrhoeal diseases remain a public health concern, particularly among children under five. This study investigates the trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone in 2008, 2013 and 2019.MethodsThe analysis utilised data from the Sierra Leone Demographic Health Survey rounds conducted in 2008, 2013, and 2019. The software utilised for the calculation of various measures of inequality, including simple difference, ratio, population-attributable risk, and population-attributable fraction, was the World Health Organization Health Equity Assessment Toolkit. An inequality assessment was conducted for six stratifiers: maternal age, maternal economic status, maternal level of education, place of residence, sex of the child, and sub-national region.ResultsOur findings reveal that children under five with diarrhoea receiving oral rehydration therapy and continued feeding increased from 56.5% in 2008 to 59.7% in 2019 in Sierra Leone. Children of mothers aged 20–49 had more coverage over time than those with mothers aged 15–19. Children of mothers who are wealthy, more educated, and living in urban areas show a decrease in coverage with time compared to the poor, the lowly educated, and those residing in rural areas. Male children had higher coverage than female children. Regional inequality decreased slightly from 21.5 percentage points in 2008 to 21.2 percentage points in 2019.ConclusionThe findings revealed a mixed picture of progress in oral rehydration therapy and continued feeding for children under five in Sierra Leone. While national coverage has increased, inequalities persist. Children of older mothers and those from disadvantaged backgrounds have experienced improvements, while children of younger, wealthier, and more educated mothers in urban areas have seen a decline in coverage. The gender and regional inequalities remain. Expanding community-based health programs, providing subsidised or free supplies, and strengthening health systems in underserved areas are key strategies to ensure equitable and effective healthcare for all children in Sierra Leone.

Short interbirth interval and adverse pregnancy outcomes: a Bayesian network approach

BackgroundInterbirth interval (IBI), the time between consecutive births, has been tied to perinatal outcomes. ObjectiveTo analyze adverse perinatal events following short IBI in a large South American sample. Study designObservational, retrospective, hospital-based study including malformed and nonmalformed live- and stillbirths. Outcomes were preterm birth (PTB), low birth weight (LBW), and specific birth defects. Logistic regressions were used to evaluate the risk of selected variables for short IBI and for adverse outcomes after short IBI, adjusting by confounders. Bayesian networks exhibited relationships among short IBI, outcomes, and variables. ResultsShort IBI rate was 2%–3%. Maternal age and a previous abortion were the main confounders. A significant high risk for short IBI was found in mothers ≤19 years while mothers ≥30 were at low risk, mediated by a previous abortion. The risk of short IBI, adjusted by confounders, was significant for LBW but not for PTB. An unadjusted risk of short IBI was observed for gastroschisis, which disappeared after adjusting for confounders. Maternal age ≤19 and previous abortion were directly related with gastroschisis; the relationship between gastroschisis and short IBI occurred through any of these two variables. A direct relationship between gastroschisis and maternal age ≥30 was observed. ConclusionsOnly young mothers were directly related with short IBI. In older mothers, a short IBI mainly occurred after a previous abortion. Short IBI was a risk factor only for LBW. The PTB and gastroschisis relationship with short IBI was indirect, mediated by young maternal age and/or a previous abortion.

The experiences of older migrant mothers and grandmothers with intergenerational solidarity in their transnational families

AbstractThe role of grandparents in providing support to their migrant adult children is well researched within the intergenerational cross‐border solidarity literature. Studies highlight the gendered care roles assumed by ‘left behind’ grandparents, usually women, who provide hands‐on caregiving to their young grandchildren. However, there is limited research on the supportive economic roles of older migrant women who help ‘left behind’ families navigate economically unpredictable circumstances through remittance transfers. This article makes a contribution by exploring the economic roles of older mothers and grandmothers who participate in the international labour market as paid care workers to support their families ‘back home.’ It draws on ethnographic research with Romanian women in their late 50s and 60s in Italy. Insight is gained into the experiences with transnational care and mobility of older mothers and grandmothers. More specifically, how expectations and demands for intergenerational solidarity in their families conditions women's migration projects, including its temporalities and the distribution of economic risks and responsibilities within the transnational family.

Birthing Unit Closures: Impacts and Opportunities in Iowa

Objective and ApproachIowa, US has experienced the closure of 41 birthing units in local hospitals since 2000, which is nearly 50% of previously available units. Public health concern about access to prenatal care and birthing support in this predominately rural state has raised attention to the value of using integrated administrative data to understand impacts and direct needed resources. This presentation will showcase a series of analyses using vital statistics birth records, hospital closure records, and statewide home visiting records to understand (a) closure impacts on relevant subgroups and (b) opportunities to strengthen outcomes through service improvements. Results suggest indirect relationships between hospital closure and child/mother outcomes through impacts on prenatal care. Some mothers (e.g., mothers with low maternal education, older mothers, and mothers with previous children) were more susceptible to negative impacts on prenatal care. Data about mother connections with other public service systems (e.g., Medicaid or WIC) suggested buffering effects for some women who were at risk for birthing unit closure impacts. Subsequent phases of research have used integrated administrative data to highlight hospital closure areas where women differentially experienced more positive outcomes to inform community outreach and identification of effective intervention efforts. Conclusions and ImplicationsThis research highlights the value of longitudinal administrative data utilized to address policy-relevant topics in public health. Results suggest opportunities to expand and replicate rural health practices that are working to mitigate risk in geographic areas where women face challenging access to a birthing hospital.

An analysis of cause-specific under-5 mortality in Bangladesh using the demographic and health survey 2011 and 2017–2018

BackgroundAs the Sustainable Development Goal 3.2.1 deadline (2030) approaches, rapidly reducing under-5 mortality (U5M) gains more prominence. However, initiatives or interventions that aided Bangladesh in achieving Millennium Development Goal 4 showed varied effectiveness in reducing certain cause-specific U5M. Therefore, this study aimed to examine the predictors of the key cause-specific mortalities.MethodsThis cross-sectional study was conducted using the Bangladesh Demographic and Health Survey 2011 and 2017-18 data. Cause-specific U5M was examined using multilevel multinomial mixed-effects analyses, and overall/all-cause U5M was examined using multilevel mixed-effects analyses. The respective estimates were compared.ResultsThe cause-specific analysis revealed that pneumonia and prematurity-related U5M were significantly associated with antenatal care and postnatal care, respectively. However, analysis of overall/all-cause U5M did not reveal any significant association with health services. Twins or multiples had a greater risk of mortality from preterm-related conditions (adjusted Relative Risk Ratio (aRRR): 38.01, 95% CI: 19.08–75.7, p < .001), birth asphyxia (aRRR: 6.52, 95% CI: 2.51–16.91, p < .001), and possible serious infections (aRRR: 11.12, 95% CI: 4.52–27.36, p < .001) than singletons. Children born to mothers 18 years or younger also exhibited a greater risk of mortality from these three causes than children born to older mothers. This study also revealed an increase in the predicted risk of prematurity-related mortality in the 2017-18 survey among children born to mothers 18 years or younger, children born to mothers without any formal education, twins or multiples and children who did not receive postnatal care.ConclusionsThis research provides valuable insights into accelerating U5M reduction; a higher risk of preterm-related death among twins underscores the importance of careful monitoring of mothers pregnant with twins or multiples through the continuum of care; elevated risk of death among children who did not receive postnatal care, or whose mothers did not receive antenatal care stresses the need to strengthen the coverage and quality of maternal and neonatal health care; furthermore, higher risks of preterm-related deaths among the children of mothers with low formal education or children born to mothers 18 years or younger highlight the importance of more comprehensive initiatives to promote maternal education and prevent adolescent pregnancy.

Ethnic, geographical and altitude considerations and maternal mortality associated with HELLP syndrome in Ecuador: a population-based cohort study

BackgroundEclampsia and pre-eclampsia rank as the third leading causes of maternal death in Ecuador, following pre-existing chronic diseases and postpartum haemorrhage, as reported by the Ecuadorian National Institute of Statistics and Census (INEC). In contrast, HELLP (Haemolysis, Elevated Liver enzymes, Low Platelet count) syndrome remains underexplored epidemiologically, not only in Latin America but globally. This study marks the first population-based investigation into HELLP syndrome incidence and mortality in Ecuador, examining geographical variations, altitude influences and ethnic backgrounds.MethodsConducted as a retrospective population-based cohort study from 2015 to 2017, this research delves into the incidence, risk factors and maternal mortality associated with HELLP syndrome in Ecuador. Utilising data from INEC and the Ecuadorian Ministry of Health, we identified HELLP syndrome cases through ICD-10 (International Classification of Diseases, tenth revision) coding in hospitalised individuals. Logistic regression analysis was employed to explore association, whilst geospatial statistical analysis focused on cantons to identify significant spatial clusters. Primary outcome measures include HELLP syndrome incidence and maternal mortality, supplying crucial insights into the syndrome’s impact on maternal health in Ecuador.ResultsThe incidence of HELLP syndrome is 0.76 (0.69–0.84)/ 1000 deliveries. Afro-Ecuadorian communities have a higher risk (Odds Ratio (OR) = 2.18 (1.03–4.63)) compared to Indigenous Ecuadorian communities. Living at mid-level or high altitude is a significant risk factor OR of 2.79 (2.19–3.55) and an OR 3.61 (2.58–5.03), respectively. Being an older mother was also identified as a risk factor. Women living more than 20 km from the obstetric unit have an OR of 2.55 (2.05–3.18). Moreover, we found that cantons with higher crude HELLP syndrome incidence also have lower numbers of physicians (R = 0.503, p-value < 0.001). The mortality incidence of women with HELLP syndrome is 21.22 (12.05–20.59)/1000 deliveries with HELLP syndrome diagnoses.ConclusionsHigh altitude, advanced maternal age and geographical distance between residence and health centres are risk factors for HELLP syndrome. Maternal mortality in women with HELLP syndrome is higher than pre-eclampsia and eclampsia but comparable with previous reports in other countries.

Determinants of Risk Factors Associated with Low Birth Weight in Nigeria

Low birth weight (LBW) remains a significant public health challenge with profound implications for neonatal and child health, particularly in low-income countries. Defined by the World Health Organization as a birth weight of less than 2.5 kilograms, LBW contributes to increased neonatal mortality and long-term developmental issues. This study examines the prevalence and determinants of LBW in Nigeria, leveraging data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study employs a cross-sectional design and a stratified two-stage sampling technique, analyzing 7,728 recorded birth weights. Key findings indicate that maternal age, education, and socio-economic status significantly influence birth weight. Optimal reproductive ages (25-34 years) and higher educational attainment are associated with healthier birth weights, whereas younger (below 20 years) and older mothers (above 40 years), and those with lower education levels, face higher LBW risks. Employment and wealth are positively correlated with better birth outcomes, underscoring the importance of financial stability. Environmental factors such as urban residence, access to improved water sources, and sanitation facilities also play crucial roles in determining birth weight. The study compares frequentist logistic regression and Bayesian structured additive logistic regression models to identify and predict LBW risk factors, highlighting regional disparities within Nigeria. The findings emphasize the need for targeted interventions addressing socio-demographic, socio-economic, and environmental determinants to reduce the prevalence of LBW and improve maternal and child health outcomes. Enhanced understanding of these factors through advanced statistical modeling can inform policy and health interventions, ultimately contributing to achieving global health targets and improving neonatal health in Nigeria.

Time trends in incidence of postpartum depression and depression in women of reproductive age

BackgroundLittle is known about the time trends of postpartum depression (PPD) and whether they differ from time trends of depression among women in general. MethodsUsing Danish health registers, we identified a postpartum population from all women who had a liveborn child from 2000-2022. We sampled a background population by matching five women for each delivery on age and date of childbirth. Depression and PPD were measured as incident depression diagnosis or redeemed antidepressant prescription within 180 days from childbirth/matching. We described incidence rates from 2000-2022 using Poisson regression with a restricted cubic spline. ResultsThe study population included 1,133,947 postpartum women (669,101 unique), matched to 5,669,735 women (1,165,505 unique). Overall IR per 10,000 person-years of diagnoses was 34.3 (95% CI: 32.8–35.9) for PPD and 18.9 (95% CI: 18.3–19.4) for depression. Both IRs increased similarly over time in the main analyses, but more pronounced for PPD in primiparous and older mothers. Correspondingly, IR for prescriptions was 135.7 (95% CI: 132.7–138.8) for PPD and 209.8 (95% CI: 208.1–211.5) for depression, and both groups had fluctuating time trends. LimitationsDepression measures were based on women who actively sought and received treatment, expectedly underestimating true disease incidence. ConclusionsIncidence rates of PPD and depression diagnoses increased over time, especially for PPD among primiparous and older mothers. These findings could suggest either increased vulnerability or increased awareness and detection over time in these groups. Fluctuating trends overserved from prescriptions could likely be driven by external factors and not a reflection of disease trends.

Reintroduction of spring‐run Chinook salmon in the San Joaquin River: Evaluating genetic and phenotypic effects of captive breeding

AbstractCaptive‐breeding programs are increasingly implemented to curb population declines but can have unintended negative effects on genetic diversity and phenotypes. Through an analysis of ~10 years of genetic monitoring, pedigree information, and phenotypic data, we evaluated a captive‐breeding program that uses adaptive management to reduce inbreeding and improve captive broodstock performance. A captive‐breeding program was established in 2012 to reintroduce spring‐run Chinook salmon to the southern edge of their range in California's San Joaquin River (SJR), using fish produced each year at the nearby Feather River Hatchery (FRH). We found that the SJR program adequately captured the genetic diversity of the FRH source population and that mate pairings guided by genetic relatedness reduced inbreeding. However, the SJR broodstock reared in captivity had smaller body size at maturity in comparison to the FRH source broodstock which matures at sea, but this effect disappeared when SJR juveniles were released from captivity to mature at sea. Phenotypic traits of SJR female parents also influenced reproductive performance; older mothers and those with smaller eggs had offspring with lower survival. These findings demonstrate that adaptive genetic monitoring and pedigree information can be powerful tools for reducing risks of captive breeding and evaluating program effectiveness.

Direct breastfeeding: Predictive factors and possible effects on neurodevelopment in very preterm infants

Backgroundthe importance of sucking milk directly at the mother's breast is often underestimated and many aspects of direct breastfeeding of very preterm infants are not investigated. AimThe primary endpoint of the study was to identify maternal and infant clinical predictors of direct breastfeeding in a cohort of infants born at <32 weeks of gestation or weighing <1500 g. The secondary endpoint was to evaluate the possible effects of direct breastfeeding on infant neurodevelopment. Study designSeventy-two infants born between July 2018 and December 2019 were divided into the subgroup that were directly breastfed (n = 42) and not directly breastfed (n = 30) at discharge. Maternal and infant characteristics were compared, and differences were analysed. ResultsLogistic regression analysis demonstrated that the percentage of maternal milk taken during hospitalization, maternal age, and weight (z-score) at discharge were positively correlated with the likelihood of direct breastfeeding at discharge. Direct breastfeeding was not correlated with the cognitive score at 24 months corrected age. ConclusionsDirect breastfeeding at discharge is more probable in infants of older mothers who receive more breastmilk and who experience greater weight gain. Direct breastfeeding is not correlated with the cognitive score at 24 months corrected age.

Maternal birthplace and experiences of perinatal healthcare in Belgium: Evidence from a cross-sectional survey

BackgroundPatient experience is an important part of perinatal care quality. Migrant women in high-income countries often report more negative experiences than non-migrants, but evidence in Europe is patchy. In this study, we compared the experiences of two migrant populations with non-migrants, taking into account socioeconomic characteristics. MethodsWe surveyed mothers born in Belgium, North-Africa, and Sub-Saharan Africa (n = 877) using an adapted version of the Migrant-Friendly Maternity Care Questionnaire. Two patient experience scores were created using multiple correspondence analyses: a) information and communication with healthcare professionals and overall satisfaction with pregnancy care, and b) patient-centred aspects and satisfaction with delivery care. Through descriptive analyses and multivariable logistic regressions we estimated the associations of maternal characteristics with each score. ResultsOverall, positive experiences were reported in terms of communication (83 %) and patient-centred care (86 %). North African immigrants with low language proficiency had higher odds of negative communication experience (especially problems understanding information) (ORa: 2.30, 95 %CI 1.17–4.50), regardless of socioeconomic position. Among women with language barriers, 88 % were never offered a professional interpreter, relying on family members for translation. Patient-centred care was not associated with maternal birth region but was rated more negatively by older mothers, those with longer residence in Belgium, and higher majority-language proficiency. ConclusionIn Belgium, perinatal care experiences were generally positive, although communication with immigrants was suboptimal. Language barriers, single motherhood, and unstable housing increased communication issues. Our findings underline the necessity to improve information-exchange with immigrants and socioeconomically vulnerable women.

Beneficial effects of short-term breastfeeding versus non-breastfeeding in early life against childhood obesity: findings from the US-based population study NHANES

BackgroundBreastfeeding is widely recognized for its potential to reduce childhood obesity. However, research investigating these benefits in children breastfed for a short duration (up to 6 months) remains limited despite this being a common practice globally.MethodsThis study focused on a population breastfed for 6 months or less to determine the potential benefits of short-term breastfeeding for preventing childhood obesity. Data were collected from five survey cycles of an US-based population study (the National Health and Nutrition Examination Survey (NHANES)), spanning 2009–2020. A sample of 3,211 children aged 2–6 years was selected, including 1,373 never breastfed and 1,838 ever breastfed. Logistic regression analysis examined the direct association between short-term breastfeeding and childhood obesity. Subsequent subgroup analyses were conducted. Additionally, stratified logistic regression explored the relationship between childhood obesity and the introduction of other early nutrition in both ever-breastfed and never-breastfed children.ResultsOverall, breastfeeding for 6 months or less did not directly prevent childhood obesity. However, among participants with older mothers (aged 35 or above), short-term breastfeeding was associated with a lower risk of childhood obesity compared to never being breastfed (OR 0.31, 95% CI: 0.17, 0.59). Similarly, children aged 3–4 years who were breastfed for > 3 ~ 6 months exhibited a lower obesity risk (OR 0.56, 95% CI: 0.35, 0.89). In ever-breastfed children, delayed infant formula introduction was linked to a lower risk of obesity (P-trend < 0.05: introduction at age ≤ 1 vs. >1 ~ 3 vs. >3 months). Conversely, for non-breastfed children, introducing milk (other than breast milk or formula) later (≥ 12 versus < 12 months) and introducing alternatives to whole cow’s milk were associated with lower obesity risks (OR 0.54, 95% CI: 0.37, 0.78; OR 0.21, 95% CI: 0.08, 0.60, respectively). Notably, these trends were not observed in ever-breastfed children.ConclusionsShort-term breastfeeding may offer some benefits in preventing childhood obesity for specific populations. Additionally, it could potentially mitigate risks associated with the introduction of formula and cow’s milk at inappropriate times.

Application of health belief model to assess periodic examination of thyroid functions in children among Saudi mothers

Background: Hypothyroidism is a common concern in the development of physical and cognitive development in children. The health belief model is one of the models that examines the factors behind people’s behaviors. Aim was to assess the periodic examination of children among Saudi mothers and its association with different constructs of the health belief model. Methods: This cross-sectional study was conducted among 385 participants of Saudi mothers for three months from January to April 2024 by using a designed structured questionnaire. Results: 88.05% of mothers showed poor behavior regarding periodic examinations of thyroid functions for their children. The significant factors that determined this behavior were the older mother’s age, working status (mother working), positive family history of hypothyroidism, good perceived benefits, and good cues to action. These factors were statistically significant at p value &lt;0.05. Conclusions: Most of the mothers who participated in this study showed poor behavior regarding the regular examination of thyroid function tests of their children. Factors such as the older mother’s age, working status (working mother), positive family history of thyroid issues, good perceived benefits of the exams, and good cues to action were found to be significantly associated with mothers’ behavior towards this regular examination of thyroid function.

Exploring Maternal Socio-Demographic Factors Shaping Children's Dietary Patterns in Brazil: Results from the 2019 National Health Survey.

This study aimed to identify the dietary patterns of Brazilian children aged 6-23 months and to investigate their association with maternal socio-demographic factors. Data from the 2019 Brazilian National Health Survey were used in this cross-sectional study. Mothers of 1616 children aged 6-23 months reported on their children's dietary intake. Dietary patterns were identified using principal component analysis, and their associations with maternal socio-demographic characteristics were assessed using linear regression models. The first consisted of healthy patterns and the second, unhealthy ones. Linear regression showed that adherence to a healthy dietary pattern was higher among children of mothers who were older (β = 0.02, p = 0.01), had more years of education (β = 0.49, p = 0.04), reported living with a partner (β = 0.29, p = 0.01), and resided in an urban area (β = 0.35, p = 0.01). Conversely, adherence to the unhealthy pattern was positively associated with mothers who declared themselves as black or brown (β = 0.25, p = 0.03). Our results show that older mothers with higher levels of education and paid work and who live with a partner are more likely to contribute to their children's healthy eating patterns. We conclude that socio-demographic factors may influence the quality of the food offered to children. Nevertheless, advocating for public policies promoting nutritious complementary diets emphasising fresh and minimally processed foods remains crucial for children whose mothers do not possess these favourable socio-demographic characteristics.

How safe is Autheem therapy for young Saudi infants? A question worth asking.

In Saudi Arabia, a traditional therapy for a folk labeled problem known as "Autheem - " is often offered to infants. The procedure involves manipulating an infant's soft palate to alleviate pain associated with infant colic and poor feeding. However, concerns remain about this procedure's impact on infant health and its potential to transmit infections. This study focused on perceptions that Saudi mothers hold about Autheem therapy. A descriptive, cross-sectional, community-based study was conducted via an online platform to reach Saudi mothers in the Riyadh region of Saudi Arabia. Five hundred and thirty-six Saudi mothers participated; half were older than 30 years of age. Despite a high rate of college degree attainment, the majority of mothers relied on their elders as a source of information (88.4%). Autheem was viewed to be a stand-alone disease by 86.5% of respondents; 71.4% believed it could not be treated with modern medicine. Most infants were under six months of age when they received Autheem therapy (72%). Roughly 13% of mothers found that their infant had a fever after the therapy; we found an association between Autheem therapy and viral illnesses. About 13% of mothers altered their child's vaccination schedule after Autheem therapy. Older mothers have more positive attitudes towards and stronger beliefs in Autheem therapy than younger mothers. The therapy's strong association with viral illnesses and its negative impact on vaccination schedules are major public health concerns.

Socioeconomic and household framework influences in school-aged children's eating habits: Understanding the parental roles

Maternal influences on children's diet have been widely studied, while paternal and household frameworks require further research. This study aimed to evaluate how individual, socioeconomic and household characteristics at birth and 7 years (y) impact children's fruit and vegetable (FV) and energy-dense foods (EDF) intake at 10y, distinguishing maternal and paternal effects. The sample included 2750 children evaluated at 7 and 10y in the Portuguese birth cohort Generation XXI. The children's food intake was assessed through a Food Frequency Questionnaire at both ages, where 4 food groups were defined: FV, ‘Sweet foods’, ‘Salty snacks’, and ‘Soft drinks’. The associations between food intake at 7y, parents' and children's characteristics, and food intake at 10y were evaluated via binary logistic regression models. Offspring of older mothers with higher age and education, who live with siblings and had higher family income were likelier to have 5 servings of FV daily at 10y. Children eating 5 portions/day of FV at 7y had higher odds of keeping this pattern at 10y. Higher maternal age and education, and father's education decreased the odds of having soft drinks daily at 10y. Higher family income was linked with lower odds of weekly salty snacks and daily sweet foods at 10y. In conclusion, parental education, maternal age, living with siblings, and higher family income influenced children's FV and EDF intake at 10y. Mothers' effects appear to impact children's food intake more than fathers'.