Father Research Articles

Profile of toddler pneumonia cases in Soewandhie Regional Hospital, Surabaya, East Java, Indonesia: A descriptive study

Introduction: Pneumonia stands as a leading cause of mortality among children under five, trailing only behind diarrhea in Indonesia, where it has claimed the lives of 740,180 young children. This study endeavors to provide a comprehensive overview of toddler pneumonia specifically within the confines of Soewandhie Regional Hospital, Surabaya, East Java, Indonesia. Objective: The primary objective of this research is to gain insight into the prevalence and characteristics of toddler pneumonia cases at Soewandhie Regional Hospital, Surabaya, East Java, Indonesia. Method: Employing descriptive quantitative methods with a cross-sectional design, the study recruited a sample of 35 toddlers meeting predefined inclusion and exclusion criteria through consecutive sampling. Data collection occurred within the Seruni room at Soewandhie Hospital, utilizing a combination of medical records examination and interviews with the families of the toddlers. Result: Among the sampled toddlers, a significant majority (65.7%) were diagnosed with pneumonia. Analysis revealed that a notable portion (51.4%) fell within the age range of 12-23 months, with a slight majority being female (54.3%). Maternal ages predominantly ranged from 20 to 35 years, while paternal ages were concentrated between 25 and 40 years (28.6%). Moreover, 17.1% of the toddlers had previously experienced pneumonia, and a majority (82.9%) were born at term with normal body weights (91.4%). Notably, two toddlers lacked complete parental care due to parental death. Conclusion: The findings underscore the significant burden of pneumonia among toddlers at Soewandhie Hospital. Future research endeavors could benefit from expanding the sample size and investigating additional factors contributing to toddler pneumonia incidence.

Parents’ age and total fertility rate in selected high-income countries from Europe and North America, 1990–2020

ObjectiveTo provide a comprehensive picture of trends in parents’ age and total fertility rate in selected most populous high-income countries from Europe and North America. Study designData were retrieved from official statistics published by the United Nations, the World Bank, the European Union (EU), and by national health statistics offices. ResultsMean maternal age at birth showed increasing trends in all considered countries; in 2020, the highest mean age was observed in Italy (32.2) and Spain (32.3), and the lowest one in the USA (28.8). Mean maternal age at first birth also showed upward trends. In the 1990s, mean age at first birth ranged from 25.5 to 26.9 years, except for the USA where it was below 25 years. The countries with the highest average maternal age at first birth were Italy and Spain, reaching 31 years over the most recent years. Data on mean paternal age at birth were scant. In Germany (2019) it was 34.6 and in the USA (2014) 27.9 years. In Italy, mean paternal age increased from 34.2 in 2000 to 35.5 in 2018, in the UK from 30.7 in 1990 to 33.4 in 2017, and in Canada, a decrease was observed from 29.1 in 2006 to 28.3 in 2011. Finally, Sweden and the USA had the highest fertility rates, around two children in some years, while Italy and Spain had the lowest ones, with less than 1.5 children over the whole period. ConclusionsMonitoring of trends in reproductive factors is crucial to gain insight into society from a cultural and sociological point of view and to analyze the impact of these changes on reproductive health and related conditions.

IVF and obstetric outcomes among women of advanced maternal age (≥45 years) using donor eggs

Research questionDoes very advanced maternal age (VAMA; age ≥45 years) influence obstetric outcomes among women using donor oocytes in IVF? DesignThis retrospective cohort study analysed data from a nationwide IVF registry in Taiwan, focusing on IVF cycles involving women aged 45 years and older using donated oocytes between 2007 and 2016. The study assessed cumulative live birth rates (CLBR) and secondary outcomes such as clinical pregnancy, miscarriage, live birth and twin pregnancy rates, alongside perinatal outcomes such as Caesarean section rates, pre-eclampsia, gestational diabetes and birthweight. ResultsThe study included 1226 embryo transfer cycles from 745 women, with a stable live birth rate of about 40% across the study period. The CLBR was slightly lower in women aged 50 years and older (54.2%) compared with those aged 45–46 years (58.0%), but these differences were not statistically significant (P = 0.647). Secondary outcomes and perinatal outcomes did not significantly differ across age groups. Regression analysis suggested a non-significant trend towards a decrease in live birth rate and birthweight with increasing maternal age. The study also found that single-embryo transfer (SET) minimized the risk of twin pregnancies without significantly affecting live birth rates. ConclusionsIVF with donor oocytes remains a viable option for women of VAMA, with consistent live birth rates across age groups. However, the study underscores the importance of elective SET to reduce the risk of twin pregnancies and associated adverse outcomes. Further research is needed to explore the impact of other factors such as paternal age and embryo development stage on IVF success in this population.

Identifying Risk of Stillbirth Using Machine Learning

(Am J Obstet Gynecol. 2023;229:327:e1–16) A tool that could help identify women at risk for stillbirth would be a welcome addition to clinical practice. Machine learning models, which can look at relationships between variables in large data sets, was investigated in this article. This study’s aim was to refine a machine learning model to predict stillbirth using data available prior to the gestational age of viability (22 to 24 wk). The researchers performed a secondary analysis of data in the Stillbirth Collaborative Research Network (SCRN), a study database of 982 stillbirths and 3000 representative live births from 2006 to 2009. The study included patients who delivered a live or stillborn fetus at >18 weeks’ gestation from 59 hospitals in 5 states (Georgia, Massachusetts, Rhode Island, Texas, and Utah). The data set included 6000 measures collected from interviews with the mother, postmortem pathological exam, cause of death analysis, and medical record Abstractsion. Subsequently 101 risk factor variables were identified and used in the model. These included maternal and biological father demographics, family history, maternal health history, prenatal lab data, fetal genetics, second-trimester screen, prenatal care history, ultrasound, and social determinants of health.

#2259 Preimplantation genetic testing in inherited kidney diseases

Abstract Background and Aims Identifying the underlying genetic cause in individuals with monogenic kidney disease allow counselling to provide prognosis and therapeutic options. In addition, discussions may extend to assessing the risk of having affected children and exploring family planning alternatives. Pre-conception counselling covers a wide range of considerations, including the expected pregnancy outcome for both mother and child, the risk of recurrence, invasive prenatal diagnosis, and the option of pre-implantation genetic testing (PGT). In this study we provide a clinical overview of PGT for monogenic kidney disease in our centre. Methods This is a retrospective cohort study of individuals with monogenic kidney disease counselled on our fertility clinic for PGT, in the Fundació Puigvert—Hospital de Sant Pau, Barcelona-Spain from January 2016 to 2023. Results During the study period, 751 visits were made to the fertility clinic, of which 8.3% (63/751) had a monogenic inherited kidney disease (IKD). Regarding the baseline characteristics of individuals with monogenic conditions, most were females (70%; 44/63). The mean age of the women was 33 years, most had no history of pregnancy prior to the first visit (73%). The mean anti-Mullerian hormone (AMH) level was 2.67 ng/ml, with 22% having levels below 1.1 ng/ml. Most cases (84%; 53/63) showed an autosomal dominant pattern of inheritance, with autosomal dominant polycystic kidney disease (ADPKD) being the primary cause in 66% of cases (42/63), followed by tuberous sclerosis complex in 8% (5/63). Autosomal recessive and X-linked disorders were each present in 8% (5/63). Table 1 shows the complete list of genetic kidney disease cases that consulted the fertility clinic. In terms of renal function, affected women had a mean renal function measured by estimated glomerular filtration rate (eGFR) of 90 mil/min/1.73 m2, with 74% having chronic kidney disease (CKD) category G1. Affected male had mean eGFR of 65 mL/min/1.73 m2, with only 38% (6/19 patients) having CKD-G1. Two (13%; 2/19) of the affected men had received a kidney transplant. Of the 63 couples who were counseled, 51% (32/63) agreed to proceed with PGT; 81% (26/32) underwent at least one cycle of ovarian stimulation, in vitro fertilization, and PGT. Fifty per cent (13/26) had a live birth child and 19% (5/26) are currently pregnant. Six couples (10%; 6/32) have pending tests. Among patients who decided not to proceed with PGT (31/63), the main reason for not doing so was that they had a spontaneous pregnancy before the first PGT cycle (35%; 11/31). Low ovarian reserve and couple´s refusal to proceed with PGT were the second most common reasons, each accounting for 22.5% of cases. In 10% (3/31) of cases, the indication for PGT was not yet approved in Spain (mainly because these patients already had a healthy living child). Maternal age over 40 years and the age of the prospective father were the reasons for not performing PGT in 6% and 3% respectively. Of note, a patient with ADPKD presented with a ruptured hepatic cyst after ovarian hormone stimulation. Therefore, PGT was discontinued after two cycles. Conclusion Women with IKD are most likely to request PGT than affected males. The most frequent condition is, by far, ADPKD. Once the technique is explained less than 50% of couples keep wishing to undergo PGT. Low ovarian reserve (which correlates quite well with age) is an important reason that impedes to go through PGT. Larger international studies are needed to understand the patient's uptake of PGT for IKD as well as the access to this technique depending on the country.

Examining determinants of stunting in Urban and Rural Indonesian: a multilevel analysis using the population-based Indonesian family life survey (IFLS).

In Indonesia, chronic malnutrition leading to stunted growth in children represents a significant issue within the public health domain. The prevalence of stunting varies between urban and rural areas, reflecting disparities in access to nutrition, healthcare, and other socioeconomic factors. Understanding these disparities is crucial for developing targeted interventions to address the issue. The study used data from the fifth wave of the Indonesian Family Life Survey (IFLS), which is a national cross-sectional population-based survey conducted across approximately 13 provinces in Indonesia in 2014-2015. Multivariate and Multilevel logistic regression models were utilized in the analysis to determine the factors associated with the prevalence of stunting in Indonesian children. The multivariate logistic regression analysis indicated that among children aged 24-59 months in Indonesia, stunting was associated with the age of the child, birth weight, maternal nutritional status, and residence. Subsequently, the multilevel logistic regression analysis revealed that in rural areas, the age of the child and birth weight exhibited significant associations with stunting. Conversely, in urban areas, stunted children were influenced by 7 factors, including the child's age (months), age of weaning, birth weight (kg), mother and father's age, place of birth, and maternal nutritional status. Variations in childhood stunting between urban and rural regions in Indonesia were observed, indicating a differential prevalence. The study's findings suggests the importance of age-appropriate nutritional support, healthcare interventions, and growth monitoring. Focused interventions are vital, potentially encompassing initiatives such as improving access to maternal and child healthcare services, promoting adequate nutrition during pregnancy and infancy, and facilitate greater parental engagement in childcare responsibilities.

Kedudukan Anak Luar Kawin Dalam Pewarisan Suku Minangkabau Ditinjau Dari Hukum Waris Adat

The status of extramarital children can be grouped into three kinship systems in Indonesia, namely patrilineal kinship, matrilineal kinship, and patrilineal kinship. The position of an extramarital child according to customary law is not the position of heirs or natural heirs of the father's descendants. Extramarital children only have a relationship with their mother and relatives. However, related to the context of the Supreme Court case law and the Constitutional Court decision Number 46/PUU-VIII/2010, this is an opportunity for extramarital children to get inheritance and legal protection from suspected biological fathers. So even an unrecognized extramarital child automatically has a civil relationship with his mother and his mother's family. Thus, the necessity of a mother to recognize her extramarital child as mentioned in the Burgerlijk Wetboek is no longer necessary. Likewise, it has been affirmed in the Constitutional Court Decision Number 46 / PUU-VIII / 2010 which is also part of legal reform, so that the child also has a juridical relationship with his biological father if it can be proven based on science technology and / or other evidence according to law.

Handling Child Victims of Incestuous Sexual Violence by The PPA Unit (A Case Study of Sexual Violence by Biological Fathers at the North Jakarta Metro Police)

The process of handling cases of incestuous sexual violence against children by the Child and Woman Protection Unit (PPA) of the Criminal Investigation Unit of the North Jakarta Metro Police Department begins with the receipt of reports from victims. Investigators provide initial services, including counseling and preliminary assessments. Legal psychology is crucial in understanding victims and compiling strong reports. Investigators use cognitive interview methods and various interviewing techniques. Victim support involves multiple parties, and inter-agency cooperation and coordination are essential to provide optimal protection and recovery for victims. Evaluating the competence of investigators in the PPA Unit of the North Jakarta Metro Police Department based on indicators set by Spencer and Spencer. This evaluation shows that investigators have adequate abilities to handle cases of child sexual violence, including incest. Motivation, physical characteristics, self-concept, knowledge, and skills of investigators are key in handling these sensitive cases. Identifying several challenges in the investigation process of child rape faced by the PPA Unit of the North Jakarta Metro Police Department. These challenges include difficulty in obtaining statements from victims, lack of direct eyewitnesses, and delays in the forensic examination process. However, the PPA Unit of the North Jakarta Metro Police Department ensures that the investigation process is carried out in accordance with applicable legal procedures, considering steps such as notifying the Prosecutor's Office, examining witnesses, preparing reports, conducting investigations, holding case hearings, and using coercion to apprehend suspects.

Age-related and species-specific methylation changes in the protein-coding marmoset sperm epigenome.

The sperm epigenome is thought to affect the developmental programming of the resulting embryo, influencing health and disease in later life. Age-related methylation changes in the sperm of old fathers may mediate the increased risks for reproductive and offspring medical problems. The impact of paternal age on sperm methylation has been extensively studied in humans and, to a lesser extent, in rodents and cattle. Here, we performed a comparative analysis of paternal age effects on protein-coding genes in the human and marmoset sperm methylomes. The marmoset has gained growing importance as a non-human primate model of aging and age-related diseases. Using reduced representation bisulfite sequencing, we identified age-related differentially methylated transcription start site (ageTSS) regions in 204 marmoset and 27 human genes. The direction of methylation changes was the opposite, increasing with age in marmosets and decreasing in humans. None of the identified ageTSS was differentially methylated in both species. Although the average methylation levels of all TSS regions were highly correlated between marmosets and humans, with the majority of TSS being hypomethylated in sperm, more than 300 protein-coding genes were endowed with species-specifically (hypo)methylated TSS. Several genes of the glycosphingolipid (GSL) biosynthesis pathway, which plays a role in embryonic stem cell differentiation and regulation of development, were hypomethylated (<5%) in human and fully methylated (>95%) in marmoset sperm. The expression levels and patterns of defined sets of GSL genes differed considerably between human and marmoset pre-implantation embryo stages and blastocyst tissues, respectively.

Relationship between personality traits and postpartum depression in Pakistani fathers.

The previous studies have found an association between Big Five personality traits and postpartum depression in women. The present study aimed to find out an association between Big Five personality traits and postpartum depression in a sample of Pakistani fathers. A total of 400 Pakistani fathers who had birth of a child in the past 1 month to 1 year period and had been living with their married partners were recruited purposively by using Google Form based survey from the major cities of Pakistan. The Urdu translated versions of Big Five Personality Inventory (BFI) and Edinburgh Postnatal Depression Scale (EPDS) were used as the main outcome measures to assess the relationship between personality traits and postpartum depression. The results found a significant negative and moderate association between Big Five personality traits and paternal postpartum depression except openness which had a weak association and neuroticism which had a positive and moderate association with PPPD (r(398) = .45). The multiple linear regression analysis found that Big Five personality traits significantly predicted paternal postpartum depression (F(5, 394) = 53.33, p = .001) except openness (B = .007, p = .98). The analysis of variance (ANOVA) found significant differences in paternal postpartum depression for age of father (F(2, 397) = 6.65, p = .001, ηp2 = .03), spouse age (F(2, 393) = 5.97, p = .003, ηp2 = .02), employment type (F(2, 395) = 9.69, p = .001, ηp2 = .04) and time spent at home (F(2, 397) = 6.23, p = .002, ηp2 = .03) while there were found no significant differences for education (F(2, 397) = 1.29, p = .27, ηp2 = .006), marital duration (F(2, 397) = 2.17, p = .11, ηp2 = .01), and birth number of recent child (F(2, 397) = 1.48, p = .22, ηp2 = .007). The study concluded that Big Five personality traits are significantly correlated with and predict paternal postpartum depression except openness which did not predict paternal postpartum depression. The occurrence of paternal postpartum depression varied significantly for age of father, age of spouse, type of employment and time spent at home.

The effect of parental age on child development at 36 months: Insights from the Japan environment and children's study

BackgroundThe impact of parent-childbearing age on child development at 36 months of age is controversial. AimsWe used data from a large cohort study with multiple imputation and mediation analyses of variables. Methods and ProceduresA total of 72,606 parent–child pairs from the Japan Environment and Children's Study were included in the study. Parents' ages were categorized into five groups. We used five domains of the Japanese translation of the Ages and Stages Questionnaire, Third Edition (J-ASQ-3). Scores below the cutoff value at 36 months were defined as developmental delays in each domain. We used three logistic analysis models. In Model 3, we analyzed maternal and paternal age using other variables and covariates. Outcomes and ResultsThe outcome was a developmental delay in the five domains of J-ASQ-3. In Model 3, ORs for the developmental delay scores regarding parental age were significantly associated with all five domains of J-ASQ-3. The mediation analysis showed a significant mediation interaction effect for mothers but localized for fathers. ConclusionAdvanced paternal and maternal ages were associated with developmental delay in children. Awareness of the risks of childbearing at an advanced age is crucial. What’s the paper addsThis manuscript used data from a large cohort study with multiple imputation and mediation analyses. With these analyses, we identified the pure effect of advanced parental age on their children’s development at 36 months.

Sociodemographic and Lifestyle Characteristics Associated with Maternal Dietary Patterns in Mexico.

There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case-control study of childhood leukemia. We obtained parents' information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called "Prudent" and "Non healthy", as well as three DPs through factor analysis, namely "Prudent", "Processed foods and fish", and "Chicken and vegetables". Characteristics associated with greater adherence to "Prudent" patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the "Processed foods and fish" pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the "Chicken and Vegetables" pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy.

Advanced Paternal Age in Focus: Unraveling Its Influence on Assisted Reproductive Technology Outcomes.

As global demographics shift toward increasing paternal age, the realm of assisted reproductive technologies (ARTs), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), faces new challenges and opportunities. This study provides a comprehensive exploration of the implications of advanced paternal age on ART outcomes. Background research highlights the social, cultural, and economic factors driving men toward later fatherhood, with a focus on the impact of delayed paternity on reproductive outcomes. Methods involve a thorough review of existing literature, centering on changes in testicular function, semen quality, and genetic and epigenetic shifts associated with advancing age. Study results point to intricate associations between the father's age and ART outcomes, with older age being linked to diminished semen quality, potential genetic risks, and varied impacts on embryo quality, implantation rates, and birth outcomes. The conclusions drawn from the current study suggest that while advanced paternal age presents certain risks and challenges, understanding and mitigating these through strategies such as sperm cryopreservation, lifestyle modifications, and preimplantation genetic testing can optimize ART outcomes. Future research directions are identified to further comprehend the epigenetic mechanisms and long-term effects of the older father on offspring health. This study underscores the need for a comprehensive approach in navigating the intricacies of delayed fatherhood within the context of ART, aiming for the best possible outcomes for couples and their children.

Prenatal &amp; Perinatal Risk Factors of Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is lifelong neurodevelopmental disorder characterized by impairments in social function, communication, and certain behaviors. The etiology of ASD is unclear &amp; it is believed to be multi-factorial, among those several prenatal &amp; perinatal factors are found to be significant. So, the necessity of this study is to detect the presence of known risk factors of ASD which in turn may help in the early diagnosis and intervention for better long-term outcomes. Objective: To find out prenatal and perinatal risk factors of ASD. Method: A case control study was conducted with 112 cases of ASD and 201 controls of 2-6 years of age. The study was carried out in Center for Neurodevelopment and Autism in Children (CNAC), in the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University and Autism Welfare Foundation (AWF). ASD was diagnosed by DSM-IV TR criteria. Mothers were interviewed and data were collected by semistructured questionnaires. Results: Total 5 risk factors were identified as the risk factors of ASD. They were: advanced paternal age (OR=2.84) and maternal age (OR=1.87); male baby (OR=2.01); environmental stress during pregnancy (OR=1.61) and preterm delivery (OR=1.80). Conclusions: It is concluded that advanced paternal age, maternal age, male baby, environmental stress during pregnancy and preterm delivery are associated with increased risk of ASD. BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 115-121

The Constitutionality of Inheritance Rights for Extramarital Children: Assessing the Legal Response under Balinese Customary Law

This article analyzes the inheritance rights of extramarital children under the post-Constitutional Court decision of Balinese customary law. Any child born of unmarried parents or out of adultery is stigmatized as an extramarital child (walad al zina) for his entire life and forbidden from inheriting an estate from his biological father. This legal issue is chosen as the main subject of this study is because of the legal circumstance in which the Balinese community does not grant status to extramarital children in matters of inheritance from the Purusa line. Hindu-Balinese religious leaders such as Parisada and the Traditional Village Council have never upheld the Constitutional Court’s ruling that states that children born out of wedlock have civil relations with their biological fathers. Islamic religious leaders have followed up on the Constitutional Court’s decision by issuing a fatwa of the Indonesian Ulema Council (MUI). The fatwa imposes an obligation on biological fathers to separate their wealth for a guarantee of life to children. Applying the statutory approach, conceptual approach, sociological approach, and case approach, it can be understood that children born out of wedlock (the Balinese call it begin at children) have no status as heirs in the Purusa line but have inheritance rights from their mother and their mother’s family.

The association between parental cardiovascular health status and the risk of obesity in their offspring: Tehran Lipid and Glucose Study

Background and aimsLittle is known about the association of parental cardiovascular risk factors with the risk of obesity in offspring. We aimed to investigate whether parental ideal cardiovascular health (ICVH) status was associated with the risk of general and central obesity in their young/adult offspring. Methods and resultsOf individuals who participated in the 2012-15 phase of the Tehran Lipid and Glucose Study, 2395 pairs of parent-unmarried offspring aged ≥6 years were selected in this cross-sectional study. General and central obesity were defined based on Iranian BMI percentile reference data for offspring aged ≤18 years. For subjects aged ≥19 years, central obesity was defined based on the introduced cut-off points for Iranian adults. We employed the American Heart Association's 2020 impact goal criteria of ICVH.The mean ± SD age of fathers and mothers were respectively 55.4 ± 9.79 and 48.4 ± 9.88. About 55% of offspring were older than 19 years. Higher adherence to ICVH score in mothers was associated with lower risk of overweight/obesity in female offspring (OR for Q1-Q4: 1, 0.56, 0.57, 0.37, P < 0.05 for all quartiles). Among ICVH components, only ideal BMI status in fathers was observed to be associated with a lower risk of overweight/obesity in their male offspring. The risk of abdominal obesity decreased in female offspring with increasing total ICVH score in mothers. ConclusionHigher adherence of parents to ICVH and its components was positively associated with a lower risk of general and abdominal obesity in their offspring. Our findings demonstrate that maternal-offspring relationship was stronger than paternal-offspring association.

The Position of Children Born from Keris Marriages in Balinese Customary Law Inheritance

Purpose: The existence of Keri's Marriage impacts the child who is born, where the child's position in terms of inheritance is questionable. It happens because first, the child who is born does not have a father who is responsible for his actions, so the mother of the child must carry out the keris marriage procession or second, the child gets recognition from his father and only during the marriage procession is his father symbolized by a keris because of his inability to attend the marriage procession or third, the child who is born carries out a peperasa or adoption ceremony.Methodology:In this study, the author uses an empirical legal research method using a statutory approach, a legal sociological approach and a case approach. Two types of data are used in empirical legal research: primary and secondary. Data collection for the preparation of this study was carried out in a village in Tabanan Regency. Findings: The research findings explain the results of research data processing, which do not include numbers but explain in detail the results carried out between research variables. They also explain the implications of research where research has a direct impact.Implication:In the case that occurred in Pandak Gede Village, the marriage procession was continued again after the arrival of the male party, so the child was administratively recognized by his biological father. In terms of inheritance, the child had the right to inherit because he received recognition from his biological father.

Intra-individual changes in sperm parameters and total motile count with time among infertile men.

Paternal age association with sperm parameters has been previously studied, demonstrating a decrease in semen volume, sperm motility, and sperm morphology, but not in sperm concentration. However, scarce data exists on the individual intra-personal changes in semen parameters with time. Retrospective cohort study. To evaluate the changes in semen parameters and total motile count of infertile men over time. In this retrospective cohort study, infertile men without known risk factors for sperm quality deterioration and at least two semen analyses done>3 months apart, between 2005 and 2021, were evaluated. Allocation to groups was according to time between first and last semen analyses - 3-12 months, 1-3 years, 3-5 years, and>5 years. Basic characteristics and first and last semen analyses were compared. The primary outcome was the change in sperm parameters and the secondary outcome was the occurrence of a total motile count<5 million in men with an initial total motile count>10 million. A total of 2018 men were included in the study. The median age at first semen analyses was 36.2 (interquartile range: 32.8-40.1) years and the median time between semen analyses was 323 days (range 90-5810 days).The overall trend demonstrated an increase in concentration in the 3-12 months and the 1-3 years groups, whereas volume, motility, and morphology remained similar in these time groups. Semen analyses done more than 5 years apart showed decreased volume (p<0.05), motility (p<0.05) morphology (p<0.05), and steady sperm concentration. Significant declines in TMCs were found over time (p<0.001), with 18% and 22% of infertile men with an initial total motile count>10 million dropping to<5 million after 3 and 5 years, respectively. The factors independently predictive of total motile count<5M in the last semen analyses in men with an initial total motile count of>10M in a multivariate logistic regression model were baseline volume (odds ratio 0.80, p=0.03), baseline total motile count (odds ratio 0.98, p=0.01) and time between semen analyses - 3-5 years (odds ratio 3.79, p<0.001) and>5 years (odds ratio 3.49, p=0.04) DISCUSSION: Our study demonstrates, at the individual level, that while improvement in sperm concentration is observed in the first year and between 1 and 3 years, possibly due to fertility treatments, fertility-related counseling, and lifestyle changes, semen parameters decline with time over 3 years in individuals. Of significance, close to 22% of men with an initial total motile count>10 million (a range where spontaneous pregnancy is attainable) declined to<5 million (a range usually indicating a need for in-vitro fertilization/intracytoplasmic sperm injection) over 5 years. This data could contribute to individualized family planning for infertile men regarding the mode and timing of conception and the need for sperm banking, in order to minimize the need for future fertility treatments.

Cerebral palsy risk in relation to parental age: insights from a matched case-control study

BackgroundCerebral palsy, a prevalent childhood physical disability, exhibits complex multifactorial causes. This case-control study explores the role of parental age in cerebral palsy risk and associated patterns.MethodsA case-control study comparing children with cerebral palsy at ages 3 months to 3 years with age-matched healthy control subjects was conducted between January 2022 and August 2023 at Federal Medical Centre, Abeokuta, Nigeria. Cases were recruited from the pediatric physiotherapy outpatient clinic, while controls were selected from pediatric and children emergency wards. Data were collected retrospectively from electronic medical records. Risk factors were evaluated using conditional logistic regression models.ResultsWe studied 134 subjects with cerebral palsy and 134 age-matched control subjects. Significant risk factors for cerebral palsy included the maternal age 35–39 years (odds ratio 2.16, P < 0.005), maternal age ≥ 40 years (odds ratio 3.83, P < 0.005), paternal age 41–45 (odds ratio 2.00, P < 0.05), paternal age ≥ 46 (odds ratio 6.80, P < 0.05), primiparous (odds ratio 2.2, P < 0.05), paternal low income (odds ratio 2.49, P < 0.05), paternal primary education (odds ratio 24.61, P < 0.05), and maternal primary education (odds ratio 2.39, P < 0.05).ConclusionsThis research contributes to our understanding of parental age as risk factors associated with cerebral palsy in children. The results also underscore the importance of demographic and socioeconomic factors, especially father’s level of income, maternal parity, and parental education. These findings can guide future research and public health interventions aimed at reducing the burden of cerebral palsy.

Effect of Family Income Level on Pediatric Upper Extremity Fracture Rate

Objective: The aim of the study was to compare the sociodemographic characteristics of children with upper extremity fractures with those of children without upper extremity fractures. Materials and Methods: A total of 161 participants (age:11.24±2.95, female:53, male:108), 100 of whom were admitted to the orthopedics and traumatology clinic in 2022 with upper extremity fractures and 61 without upper extremity fractures, were included in the study. Participants; age, height, weight, mother's education level, mother's age, father's education level, father's age and monthly income of the family were recorded. Fracture and recurrent fracture rates of the participants who were members of a family whose monthly income was below the minimum wage and those who were included in a family with a monthly income above the minimum wage were compared. Results: The age, height and weight of the participants without upper extremity fractures were greater than those with upper extremity fractures (p&amp;lt;0.01). The body mass index of those with upper extremity fractures was lower than those without upper extremity fractures (p=0.001). While the number of upper extremity fractures in the participants who were members of families with a monthly income below the minimum wage was 79 (63.70%), the number of fractures in the participants who were members of families with an income above the minimum wage was 21 (56.80%) (p=0.44). In addition, when those with upper extremity fractures were evaluated independently from those without upper extremity fractures; While the number of recurrent upper extremity fractures was 7 (33.3%) in the participants who grew up in families with an income above the minimum wage, the number of recurrent upper extremity fractures was 11 (13.9%) in the participants who grew up in families with an income above the minimum wage (p= 0.04). Conclusion: Low body mass index may increase the rate of upper extremity fractures in children. For this reason, families should be informed about the possibility of physical development of children at risk for upper extremity fractures. In addition, the rate of recurrent upper extremity fractures is higher in children of families with a relatively high monthly income. Families with relatively high incomes should be made aware of the safety measures to be taken against accidents in their living spaces.