Prevalence Of Mothers Research Articles

Evaluation of obstructive sleep apnea prevalence in mothers of infants with low birth weight and its relationship with serum uric acid levels as a hypoxia marker

Objective Serum uric acid level, which is an oxidative stress marker, may increase in some conditions that lay the ground for the hypoxia. However, recent literature lacks studies with large series on this subject. We aimed to examine the incidence of OSAS in mothers who delivered a low birth weight baby and its association with serum uric acid levels as a hypoxia marker. Methods We enrolled 143 pregnant women, 44 of whom delivered a low birth weight (LBW) baby. We made a face-to-face interview in which we asked the questions in the patient follow-up form, comprising three sections. The form included questions regarding the sociodemographic features and obstetric history of the participant women, besides the Berlin Questionnaire and the Epworth Sleepiness Scale. We recorded the blood test parameters that are obtained from patient records in the last section. Results Mean uric acid (UA) levels of mothers with a LBW baby (n = 44, birth weight below 2500 g) were 4.51 ± 1.23 mg/dL (min–max = 2.7–8.0) while the UA levels in mothers of normal weighted (NBW) babies (n = 99, birth weight is 2500 g or above) were 4.08 ± 0.75 (min–max = 2.6–6.1 mg/dL). The UA levels of mothers who delivered LBW infants were significantly higher compared with the mothers of NBW babies (p = .010). Conclusion Uric acid levels can be used as a prognostic parameter for the closer monitoring of pregnant women who have been diagnosed with small-for-gestational-age babies during pregnancy.

Serosurveillance for vaccine-preventable diseases: A look inside the pertussis experience

Serological surveillance (serosurveillance) provides the most direct measure of herd immunity of vaccine-preventable diseases. Little is known about the opportunities and challenges of serosurveillance experiences, particularly pertussis. To describe the process of serosurveillance for vaccine-preventable diseases with an emphasis on the experience of pertussis in the metropolitan area of Antioquia (Valle de Aburrá) in 2015 and 2016 and analyze the contributions and challenges for its sustainability. We described the planning and conduction of serosurveillance of pertussis antibodies of mothers and in the umbilical cord at the time of delivery in eight hospitals based on random sampling and their capacity to advance the serosurveillance periodically. We compared the contributions and the challenges of this experience with other probabilistic and non-probabilistic programs. We achieved the participation of hospitals and mothers respecting the delivery care process. We established a serum bank following ethical and technical guidelines. This program based on the random selection of hospitals and mothers has enabled the estimation of antibodies prevalence in mothers and in the umbilical cord, which has been possible given the high coverage of hospital care during childbirth at a lower cost and fewer risks than a population-based survey in conflictive areas. The main challenges for the sustainability of this program are the creation of stable jobs and access to funding and legal and methodological long-term frameworks. Hospital serosurveillance as described is an option to monitor the impact of vaccination on the population. Our experience could be reproduced in other regions under similar conditions if the above-mentioned challenges are solved.

Iron and Vitamin a Biomarkers in Mothers and Infants in Rural Uganda: Using the BRINDA Approach to Adjust for Inflammation (P10-108-19)

ObjectivesWe aimed to assess prevalence of iron and vitamin A deficiencies in Ugandan mothers and infants using the BRINDA (Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia) adjustment and to ascertain any differences by prevalence of malaria. MethodsFrom a prospective birth cohort (N = 5000) conducted in rural Uganda (2014–2016), samples from mothers (n = 1652, at birth) and infants (n = 695, 5–7 m/o) were analyzed for ferritin (FER), soluble transferrin receptor (sTFR), retinol binding protein (RBP), CRP, AGP, hemoglobin (Hb) and malaria. FER, sTFR and RBP were adjusted for inflammation using CRP and AGP. Depleted iron stores were defined as: FER <12 μg/L and <15 μg/L in children and mothers respectively; sTFR >8.3 mg/L for Fe-deficient erythropoiesis; RBP <1.05 μmol/L for vitamin A deficiency; and Hb <110 g/L for anemia. Prevalence estimates were stratified by malaria status. ResultsAdjustment for inflammation in mothers increased depleted iron stores (FER) from 7 to 12%, and decreased iron-deficient erythropoiesis (sTFR) from 27 to 22%. For children, adjustment increased depleted Fe stores from 17 to 40%, and iron-deficient erythropoiesis from 76 to 64%. Vitamin A deficiency in mothers was 9% and in infants decreased after adjustment (15% vs 4%). The prevalence of altitude adjusted anemia was 18% in mothers and 72% in infants. The prevalence of tissue iron deficiency (BIS <0 mg/kg) using adjusted sTFR and FER was 10% for mothers and 50% for infants compared to 8% and 34% using unadjusted markers respectively (Tables 1,2). Almost 14% of children (n = 75) were diagnosed with malaria. Malaria prevalence in mothers was low (5%), possibly due to the high (82%) prevalence of IPT prophylaxis reported during pregnancy. No significant differences were found in adjusted versus unadjusted estimates for Fe markers stratifying by malaria. ConclusionsFe deficiency adjusted estimates varied by biomarker and were not correlated with malaria in line with BRINDA recommendations. For mothers and children, the prevalence of Fe deficiency (sTFR) and anemia (Hb) were similar, suggesting that a big part of anemia in Uganda could be due to Fe deficiency as opposed to other micronutrients. Funding SourcesSupport provided by Feed the Future Innovation Lab for Nutrition, funded by the United States Agency for International Development (USAID). Supporting Tables, Images and/or Graphs▪▪

Mamma Mia - A randomized controlled trial of an internet-based intervention for perinatal depression.

Studies suggest that 10-15% of perinatal women experience depressive symptoms. Due to the risks, problems with detection, and barriers to treatment, effective universal preventive interventions are needed. The aim of this study was to assess the effectiveness of an automated internet intervention ('Mamma Mia') on perinatal depressive symptoms. Mamma Mia is tailored specifically to the perinatal phase and targets risk and protective factors for perinatal depressive symptoms. A total of 1342 pregnant women were randomized to an intervention ('Mamma Mia') and control group. Data were collected at gestational week (gw) 21-25, gw37, 6 weeks after birth, and 3 and 6 months after birth. We investigated whether (1) the intervention group displayed lower levels of depressive symptoms compared with the control group, (2) the effect of Mamma Mia changed over time, (3) the effect on depressive symptoms was moderated by baseline depressive symptoms, previous depression, and parity, and (4) this moderation changed by time. Finally, we examined if the prevalence of mothers with possible depression [i.e. Edinburgh Postnatal Depression Scale (EPDS)-score ⩾10] differed between the intervention and control group. Participants in the Mamma Mia group displayed less depressive symptoms than participants in the control group during follow-up [F(1) = 7.03, p = 0.008]. There were indications that the effect of Mamma Mia was moderated by EPDS score at baseline. The prevalence of women with EPDS-score ⩾10 was lower in the Mamma Mia group at all follow-up measurements. The study demonstrated the effects of the automated web-based universal intervention Mamma Mia on perinatal depressive symptoms.

THE RELATION OF MOTHERS’ NUTRITIONAL STATUS TO PRIMARY TEETH DENTAL CARIES

Objective: According to the National Health Survey in 2013, nutritional problems in Indonesia are still a concern, and caries is the most prevalent dental disease. Primary dentition is developed during a mother’s pregnancy period. Thus, mothers’ nutritional status during pregnancy could determine the health of their children’s primary dentition. This study objective was to analyze the relationship between mothers’ nutritional status and dental caries in their children’s primary teeth.Methods: In total, 281 children under 5-year-old were selected from a health screening in Depok Sub-District, West Java. Information about maternal nutritional status was collected through the mother and child’s health book. Information about dental caries was collected through clinical examinations using the dmft index.Result: The prevalence of mothers with poor nutritional status was 22.8%, and 55.2% of their children had caries. The occurrence of dental caries in primary dentition between children of mothers with poor and good nutritional status was significantly different (p&lt;0.001). The likelihood of getting caries was 1.85 times higher (95% confidence interval: 1.5–2.2) among children of mothers with poor nutritional status than among children of mothers with a good nutritional status.Conclusion: Children of mothers with a poor nutritional status would likely present with dental caries and had a higher risk of dental caries compared to children of mothers with a good nutritional status.

Prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia.

BackgroundOptimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia.MethodsThe study used routinely collected perinatal data on all live births in 2014 (N = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother’s breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1–4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors.ResultsMost mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (<20 years) and mothers who smoked cigarettes in pregnancy were more likely to cease EBF in the early postnatal period compared to older mothers (20–39 years) and those who reported not smoking cigarettes, respectively [Adjusted Odds Ratio (AOR) =2.7, 95%CI 1.9–3.8, P <0.001 and AOR = 2.5, 95%CI 2.1–3.0, P <0.001, respectively]. Intimate partner violence, assisted delivery, low socio-economic status, pre-existing maternal health problems and a lack of partner support were also associated with early cessation of EBF in the postnatal period.ConclusionsOur findings suggest that while most mothers intend to breastfeed, and commence EBF at delivery and at discharge, the maintenance of EBF in the early postnatal period is sub-optimal. This highlights the need for efforts to promote breastfeeding in the wider community along with targeted actions for disadvantaged groups and those identified to be at risk of early cessation of EBF to maximise impact.

Antiretrovirals causing severe pre-eclampsia.

Extremely low birth weight infants (ELBW) (⩽1000g) at our tertiary hospital have a much higher HIV exposure rate than bigger babies and are mainly delivered due to complications of pre-eclampsia. Studies investigating the effect of HIV or antiretroviral therapy on pre-eclampsia, a partially immune-mediated disease have produced contradictory results. To determine if there was an association between pre-eclampsia and HIV and/or antiretrovirals in the mothers of ELBW infants. A prospective database was maintained for all ELBW infants born from August 2011 till January 2013. Data included maternal information such as HIV status, antiretroviral medication (duration and type) and mode and indication for delivery. Of the 195 mothers who delivered ELBW infants, 46 (24%) were HIV positive. This is significantly different to the 17% HIV prevalence in mothers with bigger children (p=0.02). The main indication (59%) for delivery of the infant was hypertension related with the majority of these (94%) being classified as pre-eclampsia. Although HIV on its own showed no association (p=0.13), mothers who received greater than 4weeks of antiretrovirals were more likely to develop severe pre-eclampsia (p=0.007). The debate about ARVs and PET is not yet over. We postulate that in a small group of susceptible women, ARVs may trigger early severe PET. It is unclear from our study if this would be due on a toxic or immune basis.

Maternal Human Immunodeficiency Virus-Associated Hypergammaglobulinemia Reduces Transplacental Transfer of Immunoglobulin G to Plasmodium falciparum Antigens in Cameroonian Neonates.

Background. Human immunodeficiency virus (HIV) infection reduces placental transfer of antibodies from mother to the fetus for many antigens; however, conflicting data exist for transfer of immunoglobulin G (IgG) to malarial antigens. The mechanism(s) underlying reduced placental transfer is unknown.Methods. Levels of maternal and cord total IgG, IgG subclasses, and cord-to-mother ratios (CMRs) were measured in 107 mother-cord pairs to 3 malarial antigens: circumsporozoite protein (CSP), apical membrane antigen 1 (AMA-1), merozoite surface protein 1 (MSP-1), and tetanus toxoid C-fragment (TTc).Results. Immunoglobulin G levels to CSP and TTc were lower in HIV+ mothers, and cord IgG to CSP, MSP-1, and TTc were significantly lower in neonates born to HIV+ mothers (all P values <.05). The prevalence of mothers with hypergammaglobulinemia was significantly higher among HIV+ women (68%) compared with HIV− mothers (8%) (P < .0001). Maternal hypergammaglobulinemia was associated with reduction in transplacental transfer of antibodies to CSP (P = .03), MSP-1 (P = .004), and TTc (P = .012), and CMRs <1 were found for MSP-1 (odds ratio [OR] = 6.5), TTc (OR = 4.95), and IgG1 to CSP (OR = 3.75, P = .025) in statistical models adjusted for maternal IgG.Conclusions. Data confirmed that HIV infections are associated with lower cord antibody levels to malarial antigens and that hypergammaglobulinemia may contribute to reduced antibody transfer.

Talking about sex in HIV-affected families: perspectives of HIV-infected mothers and their children from a mixed-methods study

ABSTRACTSexual education in HIV-affected families could be impeded by secrecy surrounding HIV status. This paper aims to (1) examine the prevalence of mother–child communication about sexuality, (2) evaluate the impact on sexual education of disclosing the mother’s HIV-positive status to her children and (3) explore the willingness of mothers living with HIV (MLWH) to talk about sexuality with their children. A mixed-methods design (combination of quantitative and qualitative methods) was used. A total of 109 MLWH (average age: 40.7 years) and 71 of their children (average age: 16.3 years) completed a face-to-face questionnaire. Descriptive analyses and 2×2 Fisher’s exact tests were conducted to compare the occurrence of communication about nine sexual topics from the children’s and mother’s standpoint according to the children’s awareness of their mother’s HIV status or lack thereof. A subsample of 11 MLWH also took part in a semistructured interview. Interviews were analyzed using thematic content analysis. Sexually transmitted infections (STIs), puberty and dating were the three most frequently discussed subjects between MLWH and their children. Children’s awareness of their mother’s HIV status was significantly associated (p < .05) with mother–child communication about all nine subjects from the standpoint of MLWH. Children’s awareness of their mother’s HIV status was significantly associated (p < .05) with mother–child communication about contraception, condom use and STIs from the children’s standpoint. Qualitative analyses indicated that while talk about sexuality was common, MLWH raised several barriers to sexual education, including a lack of knowledge about sexuality. The results highlight the importance of targeting parental attitudes and knowledge about sexuality. Interventions should consider the mother’s willingness to disclose their HIV status and be oriented with respect to their choice.

Babies Behind Bars: An Evaluation of Prison Nurseries in American Female Prisons and Their Potential Constitutional Challenges

This note opens the prison doors and delves into the United States female prison system, primarily focusing on the positive and negative impact of nursery programs on mothers and children, along with potential constitutional claims that can be brought against these programs. Part I provides a general background about the American prison system, and briefly touches on the constitutional standards of prisoners’ rights. It also discusses the history and development of female prisons and illustrates the rapid increase of female incarceration. Part II focuses on the prevalence of mothers within the female population in prisons. Part III introduces prison nursery programs and explains their history and how they operate. Part IV discusses the positive impact prison nurseries have had on both mothers and children. Part V touches on a few negative effects and the limitations of these programs. Finally, Part VI raises three potential constitutional challenges that can be raised against prison nurseries: two arguments based on the Fourteenth Amendment Equal Protection Clause and one argument based on the Fourteenth Amendment Due Process Clause. As this note will conclude, there should be an increase in the implementation of prison nursery programs in American prisons, as the value of these programs greatly outweighs their limitations. Moreover, potential constitutional attacks on these programs should not be discouraging, as they are unlikely to prevail.

Metodologia das Pesquisas Populacionais de Saúde Materno-Infantil: uma série transversal realizada no Estado do Ceará de 1987 a 2007

Objectivo: descrever os métodos utilizados nas Pesquisas de Saúde Materno-Infantil (PESMIC) no Ceará, durante 20 anos. Métodos: a série de inquéritos realizados no período de 20 anos foi analisada nos seguintes aspectos: a) Estudos transversais em série de base populacional, com amostra representativa de 8000 famílias; b) Utilizou-se questionários e medições antropométricas, estudando-se níveis e causas de mortalidade infantil, prevalência de desnutrição da mãe e da criança, duração da amamentação, cobertura vacinal, prevalência e manejo da diarreia e acesso aos serviços de saúde materno-infantil; c) Obteve-se como resultado as variáveis desfechos (principal mortalidade infantil) e diversos determinantes materno-infantis e socioeconómicos. Resultados: o índice de resposta foi de quase 100% nos cinco inquéritos realizados (1986-2007), e ocorreram importantes mudanças nos indicadores sociodemográficos e de saúde; redução de 81% da taxa de mortalidade infantil, aumento de 43% da taxa de amamentação; índice de imunização de 95%. Observou-se aumento de 243% do índice de sobrepeso. Foram entrevistados no total somado dos cinco estudos: 177.132 residentes, sendo 47.508 mulheres e 13.049 crianças. Conclusões: recomenda-se a continuidade desses estudos utilizando-se a mesma metodologia, possibilitando analises de variações temporais.

1.2 An Enhanced, Midwifery-Led Ultrasound Service to Monitor Fetal Growth

ObjectiveAntenatal detection of intrauterine growth restriction (IUGR) is a key objective of maternity care. In 2009, 4 in 5 babies in Birmingham born with an SGA birthweight were not recognised...

Aleitamento materno exclusivo e fatores associados a sua interrupção precoce: estudo comparativo entre 1999 e 2008

OBJETIVO: Analisar os indicadores do aleitamento materno exclusivo (AME) do Hospital Universitário de Brasília (HUB) nos anos de 1999 e 2008 e identificar fatores associados a sua interrupção precoce MÉTODOS: Estudo retrospectivo transversal com análise de prontuários de crianças atendidas nos anos 1999 e 2008 no Ambulatório de Pediatria, Crescimento e Desenvolvimento do HUB. A duração do AME foi dicotomizada em até quatro meses e quatro meses ou mais, estimando as razões de prevalência para o desmame precoce (AME&lt;4 meses), utilizando-se um modelo de regressão de Poisson com variância robusta e o teste não paramétrico de Mann-Whitney para comparação do tempo de AME nos anos estudados. RESULTADOS: Foi analisado um total de 2.173 pacientes, 1.443 referentes ao ano de 1999 e 730 referentes ao ano de 2008. Observou-se um incremento de 110,7 para 123,6 dias na duração do AME de 2008 em relação a 1999 (p&lt;0,0001). O desmame precoce foi 12,6% maior em mães com até sete anos de estudo do que em mães com 11 ou mais anos de estudo (p&lt;0,05). Os demais fatores analisados não mostraram relação estatística com o desmame precoce. CONCLUSÕES: Assim como o encontrado nas capitais brasileiras e Distrito Federal, verificou-se incremento no que diz respeito à duração do AME, associado positivamente ao nível educacional materno mais elevado. Convém ressaltar, porém, que a duração observada no estudo ainda se encontra abaixo dos 180 dias recomendados pela Organização Mundial de Saúde.

Unlinked anonymous testing to estimate HIV prevalence among pregnant women in Catalonia, Spain, 1994 to 2009

This paper estimates the prevalence of human immunodeficiency virus (HIV) infections in women giving birth and women voluntarily terminating pregnancy over a period of sixteen years in Catalonia. Samples for HIV antibody detection were collected from the Neonatal Early Detection Programme for congenital metabolic diseases that covers 99% of infants born in Catalonia. The sampling method collected information of 50% of births every year and of all women attending three clinics for voluntary interruption of pregnancy. Using two sequential immunoassays we analysed unlinked anonymous blood spot samples from 549,689 newborns between 1994 and 2009 and from 31,904 women who voluntarily interrupted pregnancy between 1999 and 2006. HIV prevalence among women giving birth decreased from 3.2 per 1,000 in 1994 to 1.7 per 1,000 in 2009 (p<0.01) and the mean age of infected mothers increased from 26 years in 1994 to 32 years in 2009 (p=0.001). A decrease in HIV prevalence was also observed in women voluntarily terminating pregnancy, from 2.3 per 1,000 in 1999 to 1.0 per 1,000 in 2006 (p<0.01). In contrast, estimated HIV prevalence in mothers born outside Spain increased from 2.2 per 1,000 in 2002 to 3 per 1,000 in 2009 (p<0.01) and their average age increased from 27 years in 2003 to 31 years in 2009 (p<0.01).

Prevalence of celiac disease in parents of preterm or low birthweight newborns

Celiac disease (CD) may present with atypical symptoms, including poor pregnancy outcomes, such as preterm and low birthweight (LBW) deliveries, thus we aimed to investigate the frequency of CD in mothers and fathers of preterm or LBW newborns. In this study, 316 parents of 164 preterm or LBW newborns and 246 parents of 123 healthy newborns were included. CD was screened using tissue transglutaminase immunoglobulin A. Endoscopic duodenal biopsy was provided in the seropositive cases. Positive tissue transglutaminase immunoglobulin A was found in six (1.1%; 1/94) individuals (three mothers and three fathers); five were from the study group (1.6%; 1/63) and one was from the control group (0.4%; 1/246). CD prevalence in mothers, fathers and parents of preterm newborns was 1/57 (1.8%), 1/57 (1.8%) and 1/29 (3.5%), respectively. In the LBW group, seropositivity in fathers was 1/50 (2%) with no seropositive mothers. Biopsy-proven CD was found in 1/159 mothers (0.6%) and 1/79 fathers (1.3%). Mean birthweights of the newborns of seropositive mothers and fathers were 214 g (P < 0.05) and 320 g lower than those of seronegative ones, respectively. However, in logistic regression analysis it was found that seropositivity of mothers or fathers did not affect gestational age or birthweight of the newborns. Because the prevalence of CD in parents of preterm or LBW newborns is not statistically higher than the healthy population, routine CD screening in that group cannot be recommended at the time being. For more definite conclusions further studies are needed.

Diagnoses of newborns and mothers with carnitine uptake defects through newborn screening

Carnitine uptake defect (CUD) is an autosomal recessive fatty acid oxidation defect caused by a deficiency of the high-affinity carnitine transporter OCTN2. CUD patients may present with hypoketotic hypoglycemia, hepatic encephalopathy or dilated cardiomyopathy. Tandem mass spectrometry screening of newborns can detect CUD, although transplacental transport of free carnitine from the mother may cause a higher free carnitine level and cause false negatives during newborn screening. From Jan 2001 to July 2009, newborns were screened for low free carnitine levels at the National Taiwan University Hospital screening center. Confirmation tests included dried blood spot free acylcarnitine levels and mutation analyses for both babies and their mothers. Sixteen newborns had confirmation tests for persistent low free carnitine levels; four had CUD, six had mothers with CUD, and six cases were false positives. All babies born to mothers with CUD had transient carnitine deficiency. The six mothers with CUD were put on carnitine supplementation (50–100mg/kg/day). One mother had dilated cardiomyopathy at diagnosis and her cardiac function improved after treatment. Analysis of the SLC22A5 gene revealed that p.S467C was the most common mutation in mothers with CUD, while p.R254X was the most common mutation in newborns and children with CUD. Newborn screening allows for the detection of CUD both in newborns and mothers, with an incidence in newborns of one in 67,000 (95% CI: one in 31,600–512,000) and a prevalence in mothers of one in 33,000 (95% CI: one in 18,700–169,000). Detection of CUD in mothers may prevent them from developing dilated cardiomyopathy.

Do differences in maternal age, parity and multiple births explain variations in fetal and neonatal mortality rates in Europe? – Results from the EURO‐PERISTAT project

Perinatal mortality rates differ markedly between countries in Europe. If population characteristics, such as maternal age, parity or multiple births, contribute to these differences, standardised rates may be useful for international comparisons of health status and especially quality of care. This analysis used aggregated population-based data on fetal and neonatal mortality stratified by maternal age, parity and multiple birth from 12 countries participating in the EURO-PERISTAT project to explore this question. Adjusted odds ratios were computed for fetal and neonatal mortality and tested for inter-country heterogeneity; standardised mortality rates were calculated using a direct standardisation method. There were wide variations in fetal and neonatal mortality rates, from 3.3 to 7.1 and 2.0 to 6.0 per 1000 total and livebirths, respectively, and in the prevalence of mothers over 35 (7-22%), primiparae (41-50%) and multiple births (2-4%). These population characteristics had a significant association with mortality, although results were less consistent for primiparity. Odds ratios for older mothers and primiparae showed significant inter-country heterogeneity. The association between maternal age and fetal mortality declined as the prevalence of older mothers in the population increased. Standardised rates did not substantially change inter-country rankings and demographic characteristics did not explain the higher mortality observed in some countries. Our results do not support the use of mortality rates standardised for age, parity and multiple births for international comparisons of quality of care. Further research should explore why the negative effects of older maternal age decrease as delayed childbearing becomes more common and, in particular, whether this is due to changes in the social characteristics of older mothers or in health care provision.

Micronutrient deficiency and the prevalence of mothers’ overweight/obesity in Egypt

I examine the relationship between micronutrient deficiency and the prevalence of mothers’ overweight/obesity in Egypt using the 1997 Egyptian Integrated Household Survey. The ordered logit results show an overlap between micronutrient deficiency and the prevalence of mothers’ overweight/obesity in Egypt. The odds of being overweight/obese are 80.8% higher for micronutrient deficient mothers than for non-deficient mothers, keeping all other variables constant. These results have at least two interesting policy implications. First, as the potential impact of the interaction between micronutrient deficiency and chronic diseases is not well known, the coexistence of micronutrient deficient and overweight/obese women can raise new and serious public health problems in the country. Second, the Egyptian food subsidy program, which lowers the relative prices of energy-dense, nutrient-poor food items, can be one of the major factors for the emergence of overweight/obese and micronutrient deficient mothers in the country. Changing the orientation of the food subsidy program may help to simultaneously address this double burden of mothers’ malnutrition.

Food Insecurity and the Risks of Depression and Anxiety in Mothers and Behavior Problems in their Preschool-Aged Children

We sought to determine if the prevalence of depression and anxiety in mothers and the prevalence of behavior problems in preschool-aged children are more common when mothers report being food insecure. A cross-sectional survey of 2870 mothers of 3-year-old children was conducted in 2001-2003 in 18 large US cities. On the basis of the adult food-security scale calculated from the US Household Food Security Survey Module, mothers were categorized into 3 levels: fully food secure, marginally food secure, and food insecure. The 12-month prevalence in mothers of a major depressive episode and generalized anxiety disorder was assessed by the Composite International Diagnostic Interview-Short Form. A child behavior problem in > or = 1 of 3 domains (aggressive, anxious/depressed, or inattention/hyperactivity) was based on the Child Behavior Checklist. Seventy-one percent of the respondents were fully food secure, 17% were marginally food secure, and 12% were food insecure. After adjustment for sociodemographic factors plus maternal physical health, alcohol use, drug use, prenatal smoking, and prenatal physical domestic violence, the percentage of mothers with either major depressive episode or generalized anxiety disorder increased with increasing food insecurity: 16.9%, 21.0%, and 30.3% across the 3 levels. Among children, after further adjustment for maternal major depressive episode and generalized anxiety disorder, the percentage with a behavior problem also increased with increasing food insecurity: 22.7%, 31.1%, and 36.7%. Mental health problems in mothers and children are more common when mothers are food insecure, a stressor that can potentially be addressed by social policy.

Seroepidemiologic studies of serotype VIII group B Streptococcus in Japan.

Levels of antibody to serotype VIII group B Streptococcus (GBS) were surveyed in serum samples from 583 pregnant women, from 461 neonates born to these women, and from 4 mother-and-neonate pairs with early-onset serotype VIII sepsis. Colonization by serotype VIII GBS was associated with significantly higher serum concentrations of serotype-specific antibodies (geometric mean [GM], 5.53 micro g/mL), compared with both noncolonization (1.53 micro g/mL) and colonization with other serotypes (2.19 micro g/mL). There was excellent correlation between antibody levels in mothers and those in their neonates. The prevalence of positive antibody levels, when arbitrarily defined, according to antibody levels in neonatal sepsis (GM, 0.49 micro g/mL) as >1.0 micro g/mL, was 58% of all pregnant women and 85% of the women colonized by serotype VIII. This high serotype prevalence may explain, at least in part, why serotype VIII causes early-onset neonatal disease at rates lower than those which would be expected on the basis of its prevalence in mothers in Japan who are colonized by GBS.