Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor h...Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.展开更多
Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary re...Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary report was released early March 2012. The information given so far does not allow for a complete evaluation of the present health situation in Morocco. However, a partial equity analysis can be devoted to the comparison of health indicators in terms of gender and urban-rural gaps. Method: 1) Questionnaires: a household questionnaire dealt with household characteristics, general health, housing condition and anthropometric data for children less than six years of age. A second questionnaire was devoted specifically to ever married women and dealt with their resources, marriage, reproductive health, family planning, AIDS/SIDA, healthcare and nutrition. 2) Data collection: data were collected through the national survey using a three-stage stratified sampling design to select 640 clusters covering the 16 Moroccan regions. A total of 15,577 households were randomly drawn, providing a sample of 75,061 individuals (51.1% females and 48.9% males) for investigation. 3) Analysis: in this short report, we relied only on partial data released by the Ministry of Health in a preliminary report. We used absolute differences and relative ratios to study the evolution of gender and urban-rural gaps on the basis of socioeconomic indicators. Results and Discussion: The Moroccan population seems to be in the last phase of its demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 in 2011. The mean age of first marriage went from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 in 2011 for men and women respectively. The age structure is showing a trend of ageing population. Generally, health indicators related to reproductive and women’s health improved noticeably and consequently, maternal and infant mortality also decreased. However, while these achievements are praiseworthy as national averages, they remain insufficient in terms of equitable healthcare and access to health services since there is still a long way to go in order to reduce the huge gender gaps and rural-urban disparities. Conclusion: In this short report, we showed that, as averages, health indicators improved noticeably during the last decade but gender inequality and urban-rural disparities are still challenging health decision makers. Moroccan health decision makers are urged to adopt an equitable health strategy, starting by giving access to data for analysis, monitoring and evaluation.展开更多
This study examines relationship between drinking cows’ milk at breakfast and several mental and physical characteristics (the diurnal type, sleep habits and mental condition as anger, out of control of emotion, irri...This study examines relationship between drinking cows’ milk at breakfast and several mental and physical characteristics (the diurnal type, sleep habits and mental condition as anger, out of control of emotion, irritation and depression) of Japanese small children aged 1 - 6 years old. A questionnaire study and an intervention one were performed in this study. An integrated questionnaire was administered, in July 2014 to 1112 participants attending one of 10 nursery school and 1 kindergarten located in Kochi (33°N, 133°E), Japan, and 582 parents (mostly mothers) which answered it instead of children (rate of answer: 51.9%). Intervention was done to 111 children attending the kindergarten. Seventy six parents answered the questionnaire which was administered 3 months after the intervention days of 21 (rate of answer: 51.9%). There are two contents of intervention, one is the distribution of cows’ milk for 21 days to be drunk at breakfast and another is the distribution of leaflet entitled “Go to bed early! Get up early! and Take nutritionally rich breakfast and cows’ milk!” just before the intervention. Just before the intervention, letter was distributed to 111 parents who were asked for their children to follow the contents of the leaflet and drink the cows’ milk distributed every day for the 21 days. Small children who drink cows’ milk at breakfast more than once per week and take nutritionally rich breakfast more than 4 times per week are more morning-typed than the other three groups in which children fit into one or none of the two issues of taking morning cows’ milk and rich breakfast (p p = 0.004). Also there was positive correlation between the implementation value for the 21 days and the diurnal type score 3 months later (r = 0.301, p = 0.018). Drinking cows’ milk at breakfast seems to be effective for small children to become more morning-typed through two sets of syntheses from tryptophan via serotonin into melatonin in the evening.展开更多
Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a si...Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a single baby at term were recruited with a total 435 mothers participating in the study. Outcome measures: Data were collected 6 months after delivery using General Health Questionnaire (GHQ-28), Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS) as well as socio-demographic and medical information at 6 months. Additionally, salivary cortisol and chromogranin levels were determined. Results: The proportion of breast-feeding mothers in the vaginal delivery group (51.4%) was significantly higher than that of the cesarean section group (24%). GHQ-28 scores were significantly related to EPDS scores and MIBS scores (P Conclusion: Maternal general health is associated with maternal psychological health. These results suggest that the support of maternal health is important to maintain maternal psychological status and bonding to infants. Because EPDS scores were significantly worse in the planned cesarean section group (4.2 ± 3.3), careful management is needed of mothers who deliver by planned cesarean section.展开更多
Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to ex...Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to exclusively breastfeed the infant during the first six months. The origins of these modern breastfeeding campaigns can be traced back to the beginning of the twentieth century. Whereas high infant mortality rates traditionally were considered to be a matter of fate and the declining birth rates towards the end of the nineteenth century raised fears about the nation’s future and led to the emergence of an increasing infant welfare movement in imperial Germany. As low breastfeeding rates were identified as a key factor behind the high infant mortality rates, the main objective of the infant care movement was to increase breastfeeding. The paper examines how the context of infant care and infant mortality was constructed and how breastfeeding campaigns in the context of infant mortality, breastfeeding rates and socio-political changes developed during the twentieth century. Thus the paper covers the period from the beginnings of social paediatrics at the beginning of the 20th century, the breastfeeding campaigns embedded into Nazi ideology during the Third Reich, until the declining breastfeeding ratios and the “feeding on demand”-movement in the 1970s as well as the ideological differences between West and East Germany during the Cold War.展开更多
Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evide...Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evidence from good quality studies that include meta-analyses and randomized controlled trials showed that MC provides strong protection against: urinary tract infections and, in infancy, renal parenchymal disease;phimosis;paraphimosis;balanoposthitis;foreskin tearing;some heterosexually transmitted infections including HPV, HSV-2, trichomonas, HIV, and genital ulcer disease;thrush;inferior hygiene;penile cancer and possibly prostate cancer. In women, circumcision of the male partner protects against HPV, HSV-2, cervical cancer, bacterial vaginosis, and possibly Chlamydia. MC has no adverse effect on sexual function, sensitivity, penile sensation or satisfaction and may enhance the male sexual experience. Adverse effects are uncommon (<1%), and virtually all are minor and easily treated. For maximum benefits, safety, convenience and cost savings, MC should be performed in infancy and with local anesthesia. A risk-benefit analysis shows benefits exceed risks by a large margin. Over their lifetime up to half of uncircumcised males will suffer a medical condition as a result of retaining their foreskin. The ethics of infant MC and childhood vaccination are comparable. Our analysis finds MC is beneficial, safe and cost-effective, and should optimally be performed in infancy. In the interests of public health and individual wellbeing, adequate parental education, and steps to facilitate access and affordability should be encouraged in developed countries.展开更多
Objective: The objective was to identify spatial distribution patterns for preventable infant mortality and the main causes of death in three municipalities of Paraná state, Brazil. Design and Sample: Ecological ...Objective: The objective was to identify spatial distribution patterns for preventable infant mortality and the main causes of death in three municipalities of Paraná state, Brazil. Design and Sample: Ecological study on infant mortality among residents of the municipalities of Maringá, Sarandi and Pai?andu, between 2004 and 2008. Measures: Data were obtained from reports by the Infant Mortality Prevention Committee, georeferenced in 19 Demographic Expansion Areas and analyzed statistically using Local Moran’s Index. Results: Of the 284 deaths among children under one year of age, 68.7% were considered preventable, and higher percentages were found in outlying areas. The main causes were illnesses originated during the perinatal period (73.8%), external causes (11.3%) and diseases of the respiratory system (5.1%). Conclusion: It is necessary to implement actions and policies on child and prenatal assistance, in order to reduce the inequality observed between the central and outlying areas of the region under study.展开更多
Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa...Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.展开更多
Background: Nutritional knowledge and practise is an important measure to improve dietary habits and food choices. The daily food should contain balanced nutrition as needed to support optimal growth, avoid deficiency...Background: Nutritional knowledge and practise is an important measure to improve dietary habits and food choices. The daily food should contain balanced nutrition as needed to support optimal growth, avoid deficiency diseases and prevent the diseases which might interfere with the children health. Materials & Methods: A descriptive cross-sectional non-interventional hospital-based study was carried out among 122 mothers and 122 children by using a non-probability convenience sampling technique in the period of 15 March to 15 April 2023, and using interviews with structural questionnaires, the data was analyzed using SPSS version 26. Results: We found that most of the children had moderate health, while most of the mothers had moderate nutritional knowledge and practise towards their children, also we found that the relationship between mothers’ knowledge and practise and child health was significant (P Conclusion: Mothers’ knowledge and practise among children was moderate and children had moderate health. Wrong beliefs and cultural taboos play major roles in decreasing knowledge and practise.展开更多
Despite several national programs to reduce infant mortality, India had repeatedly failed to achieve its set targets for infant mortality. There are approximately one million neonatal deaths in India each year which a...Despite several national programs to reduce infant mortality, India had repeatedly failed to achieve its set targets for infant mortality. There are approximately one million neonatal deaths in India each year which accounts for nearly two-thirds of the infant deaths in India. India’s current trajectories of neonatal and infant mortality rates make it unlikely that it will achieve its targets for infant mortality rate for 2015 set under the Millennium Development Goals. Since two-thirds of infant deaths in India are neonatal deaths, implementation of effective neonatal care strategies would be essential to reduce infant mortality considerably. The history of child health services in India suggests an inattention to qualitative parameters, hindering a reversal of its failures. We discuss a format of mixed-methods participatory research, integrated with routine district level household surveys (DLHS), as a model of health services research which would better delineate the problems encountered in delivering effective newborn care at the primary care level.展开更多
<strong>Purpose:</strong> We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). <strong>Method:</strong> The Peds...<strong>Purpose:</strong> We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). <strong>Method:</strong> The PedsQL<sup>TM</sup> Infant Scales—an instrument specifically designed for infants aged 1 - 24 months—were translated into Japanese. Forward and backward translations were performed, evaluating the semantic and conceptual equivalencies. Parents with infants younger than two-years-old were recruited and interviewed using think-aloud and probing techniques. Participants completed the questionnaire while speaking aloud about what came to their mind, what they thought each question meant, and how they reached each answer. <strong>Results:</strong> Seven mothers and three fathers participated. The median age was 33.4 (28 - 43) years. Four had infants younger than six-months-old. All infants were healthy. Parents’ perceptions of their infants’ HRQOL varied across their ages. Some parents with infants younger than six months experienced difficulty discussing “emotional functioning” and “cognitive functioning” because their infants were too young to articulate the actions mentioned in the items. In those cases, the parents responded, “never a problem”. Seventy-five percent of parents recalled their infants’ daily “physical functioning”, while only 58% recalled “physical symptoms”. Some parents’ perceptions and judgment formation were compromised by their own perceptions. For example, they answered “often a problem” when the items were problematic to themselves instead of to their child. However, many distinguished their infants’ HRQOL from their own perceptions, indicating they understood the intention of the questionnaire. <strong>Conclusion:</strong> Parents’ formed judgement may compromise by their own perceptions. The result of this study will be helpful in improving healthcare communication and interpreting parents’ judgments of their infants’ HRQOL in future studies.展开更多
Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, t...Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.展开更多
BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both...BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both mother and baby.AIM To investigate the relationships between FI and pregnancy outcomes,particularly GDM and PIH,while also examining the mediating role of the dietary diversity score(DDS).METHODS A cross-sectional study was undertaken to examine this relationship,involving 600 pregnant women.Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes.The FI was measured via the Household Food Security Survey Module,with GDM defined as fasting plasma glucose levels of≥5.1 mmol/L or a 2-hour oral glucose tolerance test value of≥8.5 mmol/L.The DDS is determined by evaluating one's food consumption based on nine distinct food groups.A logistic regression model was used to explore the relationship between FI and PIH,and GDM.RESULTS Seventeen percent of participants reported experiencing FI during pregnancy.The study found a significant association between FI and an elevated risk of GDM[odds ratio(OR)=3.32,95%CI:1.2-5.4].Once more,food-insecure pregnant women had higher rates of PIH(OR=0.10,95%CI:0.02-0.45)and they also faced a higher likelihood of neonatal complications,such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight.The FI wasfurther linked to metabolic disruptions,such as elevated fasting blood sugar(FBS),low-density lipoprotein cholesterol,and triglyceride levels.Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM.In particular,the mediation analysis showed that approximately 65%of the effect was mediated through DDS(P=0.002).CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health.Additionally,the study explored how DDS mediates the relationship between FI and the incidence of GDM.展开更多
BACKGROUND Human milk oligosaccharides(HMOs)are bioactive components of breast milk with diverse health benefits,including shaping the gut microbiota,modulating the immune system,and protecting against infections.HMOs...BACKGROUND Human milk oligosaccharides(HMOs)are bioactive components of breast milk with diverse health benefits,including shaping the gut microbiota,modulating the immune system,and protecting against infections.HMOs exhibit dynamic secretion patterns during lactation,influenced by maternal genetics and environ-mental factors.Their direct and indirect antimicrobial properties have garnered significant research interest.However,a comprehensive understanding of the secretion dynamics of HMOs and their correlation with antimicrobial efficacy remains underexplored.AIM To synthesize current evidence on the secretion dynamics of HMOs during lactation and evaluate their antimicrobial roles against bacterial,viral,and protozoal pathogens.METHODS A systematic search of PubMed,Scopus,Web of Science,and Cochrane Library focused on studies investigating natural and synthetic HMOs,their secretion dynamics,and antimicrobial properties.Studies involving human,animal,and in vitro models were included.Data on HMO composition,temporal secretion patterns,and mechanisms of antimicrobial action were extracted.Quality assess-ment was performed using validated tools appropriate for study design.RESULTS A total of 44 studies were included,encompassing human,animal,and in vitro research.HMOs exhibited dynamic secretion patterns,with 2′-fucosyllactose(2′-FL)and lacto-N-tetraose peaking in early lactation and declining over time,while 3-fucosyllactose(3-FL)increased during later stages.HMOs demonstrated significant antimicrobial properties through pathogen adhesion inhibition,biofilm disruption,and enzymatic activity impairment.Synthetic HMOs,including bioengineered 2′-FL and 3-FL,were structurally and functionally comparable to natural HMOs,effectively inhibiting pathogens such as Pseudomonas aeruginosa,Escherichia coli,and Campylobacter jejuni.Additionally,HMOs exhibited synergistic effects with antibiotics,enhancing their efficacy against resistant pathogens.CONCLUSION HMOs are vital in antimicrobial defense,supporting infant health by targeting various pathogens.Both natural and synthetic HMOs hold significant potential for therapeutic applications,particularly in infant nutrition and as adjuncts to antibiotics.Further research,including clinical trials,is essential to address gaps in knowledge,validate findings,and explore the broader applicability of HMOs in improving maternal and neonatal health.展开更多
Taking into account the hierarchical structure of the data, through two-level analysis on infant mortality available under second round of National family Health Survey, the same group of authors recently reported det...Taking into account the hierarchical structure of the data, through two-level analysis on infant mortality available under second round of National family Health Survey, the same group of authors recently reported determinants of infant mortality while examining possible changes in results under traditional regression analysis that ignores hierarchical structure of data. They reported that the community (e.g., state) level characteristics still have a major role regarding infant mortality in India. For better epidemiological understanding, the present study is to assess determinants of infant mortality in rural India, where three level considerations were possible. The results indicate that even after consideration of these covariates, variation in infant mortality remains significant not only between States but also between Districts. Further, as an additional observation, the probability of infant mortality is still high in rural areas of districts having health facility beyond three kilometers than their counterparts.展开更多
目的探讨早产儿出生时血清类胡萝卜素水平与其健康状况之间的相关性。方法回顾性分析2021年7月至2023年7月在赣州市人民医院新生儿科接受治疗的11名出生胎龄<37周早产儿的临床资料。收集早产儿的基础信息(如性别、胎龄、体质量、Apga...目的探讨早产儿出生时血清类胡萝卜素水平与其健康状况之间的相关性。方法回顾性分析2021年7月至2023年7月在赣州市人民医院新生儿科接受治疗的11名出生胎龄<37周早产儿的临床资料。收集早产儿的基础信息(如性别、胎龄、体质量、Apgar评分等)及血清类胡萝卜素水平。分析早产儿血清类胡萝卜素水平,采用Spearman相关分析早产儿血清类胡萝卜素与Apgar评分的相关性,并比较血清类胡萝卜素不同浓度早产儿的Apgar评分。结果11名早产儿中男性5名(45.5%),女性6名(54.5%);出生胎龄31.3~35.7周,平均(34.0±1.7)周;出生体质量1100~2200 g,平均(1905.5±827.8)g;1 min Apgar评分6~10分,平均(9±1.3)分,5 min Apgar评分8~10分,平均(9.8±0.6)分。早产儿的血清叶黄素、玉米黄质和β-隐黄质的中位水平分别为0.098 g/m L,0.042 g/m L和0.40 g/m L;Spearman相关分析结果显示,早产儿的血清叶黄素类胡萝卜素水平与1 min Apgar评分及5 min Apgar评分均无相关性(P>0.05);血清高浓度叶黄素组和玉米黄质组早产儿的1 min Apgar评分明显高于低浓度组,差异均有统计学意义(P<0.05),但高低浓度β-隐黄质组的早产儿的1 min Apgar评分比较差异无统计学意义(P>0.05)。结论本研究未能发现早产儿血清类胡萝卜素水平与Apgar评分之间的相关性。然而,高浓度叶黄素和玉米黄质可能对早产儿的短期健康状况(如Apgar评分)有积极影响。因此,在早产儿的护理中,关注血清类胡萝卜素的水平可能具有重要的临床意义。展开更多
基金Supported by Brazil Higher Education Consortia Program(CAPES).
文摘Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.
文摘Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary report was released early March 2012. The information given so far does not allow for a complete evaluation of the present health situation in Morocco. However, a partial equity analysis can be devoted to the comparison of health indicators in terms of gender and urban-rural gaps. Method: 1) Questionnaires: a household questionnaire dealt with household characteristics, general health, housing condition and anthropometric data for children less than six years of age. A second questionnaire was devoted specifically to ever married women and dealt with their resources, marriage, reproductive health, family planning, AIDS/SIDA, healthcare and nutrition. 2) Data collection: data were collected through the national survey using a three-stage stratified sampling design to select 640 clusters covering the 16 Moroccan regions. A total of 15,577 households were randomly drawn, providing a sample of 75,061 individuals (51.1% females and 48.9% males) for investigation. 3) Analysis: in this short report, we relied only on partial data released by the Ministry of Health in a preliminary report. We used absolute differences and relative ratios to study the evolution of gender and urban-rural gaps on the basis of socioeconomic indicators. Results and Discussion: The Moroccan population seems to be in the last phase of its demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 in 2011. The mean age of first marriage went from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 in 2011 for men and women respectively. The age structure is showing a trend of ageing population. Generally, health indicators related to reproductive and women’s health improved noticeably and consequently, maternal and infant mortality also decreased. However, while these achievements are praiseworthy as national averages, they remain insufficient in terms of equitable healthcare and access to health services since there is still a long way to go in order to reduce the huge gender gaps and rural-urban disparities. Conclusion: In this short report, we showed that, as averages, health indicators improved noticeably during the last decade but gender inequality and urban-rural disparities are still challenging health decision makers. Moroccan health decision makers are urged to adopt an equitable health strategy, starting by giving access to data for analysis, monitoring and evaluation.
文摘This study examines relationship between drinking cows’ milk at breakfast and several mental and physical characteristics (the diurnal type, sleep habits and mental condition as anger, out of control of emotion, irritation and depression) of Japanese small children aged 1 - 6 years old. A questionnaire study and an intervention one were performed in this study. An integrated questionnaire was administered, in July 2014 to 1112 participants attending one of 10 nursery school and 1 kindergarten located in Kochi (33°N, 133°E), Japan, and 582 parents (mostly mothers) which answered it instead of children (rate of answer: 51.9%). Intervention was done to 111 children attending the kindergarten. Seventy six parents answered the questionnaire which was administered 3 months after the intervention days of 21 (rate of answer: 51.9%). There are two contents of intervention, one is the distribution of cows’ milk for 21 days to be drunk at breakfast and another is the distribution of leaflet entitled “Go to bed early! Get up early! and Take nutritionally rich breakfast and cows’ milk!” just before the intervention. Just before the intervention, letter was distributed to 111 parents who were asked for their children to follow the contents of the leaflet and drink the cows’ milk distributed every day for the 21 days. Small children who drink cows’ milk at breakfast more than once per week and take nutritionally rich breakfast more than 4 times per week are more morning-typed than the other three groups in which children fit into one or none of the two issues of taking morning cows’ milk and rich breakfast (p p = 0.004). Also there was positive correlation between the implementation value for the 21 days and the diurnal type score 3 months later (r = 0.301, p = 0.018). Drinking cows’ milk at breakfast seems to be effective for small children to become more morning-typed through two sets of syntheses from tryptophan via serotonin into melatonin in the evening.
文摘Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a single baby at term were recruited with a total 435 mothers participating in the study. Outcome measures: Data were collected 6 months after delivery using General Health Questionnaire (GHQ-28), Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS) as well as socio-demographic and medical information at 6 months. Additionally, salivary cortisol and chromogranin levels were determined. Results: The proportion of breast-feeding mothers in the vaginal delivery group (51.4%) was significantly higher than that of the cesarean section group (24%). GHQ-28 scores were significantly related to EPDS scores and MIBS scores (P Conclusion: Maternal general health is associated with maternal psychological health. These results suggest that the support of maternal health is important to maintain maternal psychological status and bonding to infants. Because EPDS scores were significantly worse in the planned cesarean section group (4.2 ± 3.3), careful management is needed of mothers who deliver by planned cesarean section.
文摘Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to exclusively breastfeed the infant during the first six months. The origins of these modern breastfeeding campaigns can be traced back to the beginning of the twentieth century. Whereas high infant mortality rates traditionally were considered to be a matter of fate and the declining birth rates towards the end of the nineteenth century raised fears about the nation’s future and led to the emergence of an increasing infant welfare movement in imperial Germany. As low breastfeeding rates were identified as a key factor behind the high infant mortality rates, the main objective of the infant care movement was to increase breastfeeding. The paper examines how the context of infant care and infant mortality was constructed and how breastfeeding campaigns in the context of infant mortality, breastfeeding rates and socio-political changes developed during the twentieth century. Thus the paper covers the period from the beginnings of social paediatrics at the beginning of the 20th century, the breastfeeding campaigns embedded into Nazi ideology during the Third Reich, until the declining breastfeeding ratios and the “feeding on demand”-movement in the 1970s as well as the ideological differences between West and East Germany during the Cold War.
文摘Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evidence from good quality studies that include meta-analyses and randomized controlled trials showed that MC provides strong protection against: urinary tract infections and, in infancy, renal parenchymal disease;phimosis;paraphimosis;balanoposthitis;foreskin tearing;some heterosexually transmitted infections including HPV, HSV-2, trichomonas, HIV, and genital ulcer disease;thrush;inferior hygiene;penile cancer and possibly prostate cancer. In women, circumcision of the male partner protects against HPV, HSV-2, cervical cancer, bacterial vaginosis, and possibly Chlamydia. MC has no adverse effect on sexual function, sensitivity, penile sensation or satisfaction and may enhance the male sexual experience. Adverse effects are uncommon (<1%), and virtually all are minor and easily treated. For maximum benefits, safety, convenience and cost savings, MC should be performed in infancy and with local anesthesia. A risk-benefit analysis shows benefits exceed risks by a large margin. Over their lifetime up to half of uncircumcised males will suffer a medical condition as a result of retaining their foreskin. The ethics of infant MC and childhood vaccination are comparable. Our analysis finds MC is beneficial, safe and cost-effective, and should optimally be performed in infancy. In the interests of public health and individual wellbeing, adequate parental education, and steps to facilitate access and affordability should be encouraged in developed countries.
文摘Objective: The objective was to identify spatial distribution patterns for preventable infant mortality and the main causes of death in three municipalities of Paraná state, Brazil. Design and Sample: Ecological study on infant mortality among residents of the municipalities of Maringá, Sarandi and Pai?andu, between 2004 and 2008. Measures: Data were obtained from reports by the Infant Mortality Prevention Committee, georeferenced in 19 Demographic Expansion Areas and analyzed statistically using Local Moran’s Index. Results: Of the 284 deaths among children under one year of age, 68.7% were considered preventable, and higher percentages were found in outlying areas. The main causes were illnesses originated during the perinatal period (73.8%), external causes (11.3%) and diseases of the respiratory system (5.1%). Conclusion: It is necessary to implement actions and policies on child and prenatal assistance, in order to reduce the inequality observed between the central and outlying areas of the region under study.
文摘Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.
文摘Background: Nutritional knowledge and practise is an important measure to improve dietary habits and food choices. The daily food should contain balanced nutrition as needed to support optimal growth, avoid deficiency diseases and prevent the diseases which might interfere with the children health. Materials & Methods: A descriptive cross-sectional non-interventional hospital-based study was carried out among 122 mothers and 122 children by using a non-probability convenience sampling technique in the period of 15 March to 15 April 2023, and using interviews with structural questionnaires, the data was analyzed using SPSS version 26. Results: We found that most of the children had moderate health, while most of the mothers had moderate nutritional knowledge and practise towards their children, also we found that the relationship between mothers’ knowledge and practise and child health was significant (P Conclusion: Mothers’ knowledge and practise among children was moderate and children had moderate health. Wrong beliefs and cultural taboos play major roles in decreasing knowledge and practise.
文摘Despite several national programs to reduce infant mortality, India had repeatedly failed to achieve its set targets for infant mortality. There are approximately one million neonatal deaths in India each year which accounts for nearly two-thirds of the infant deaths in India. India’s current trajectories of neonatal and infant mortality rates make it unlikely that it will achieve its targets for infant mortality rate for 2015 set under the Millennium Development Goals. Since two-thirds of infant deaths in India are neonatal deaths, implementation of effective neonatal care strategies would be essential to reduce infant mortality considerably. The history of child health services in India suggests an inattention to qualitative parameters, hindering a reversal of its failures. We discuss a format of mixed-methods participatory research, integrated with routine district level household surveys (DLHS), as a model of health services research which would better delineate the problems encountered in delivering effective newborn care at the primary care level.
文摘<strong>Purpose:</strong> We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). <strong>Method:</strong> The PedsQL<sup>TM</sup> Infant Scales—an instrument specifically designed for infants aged 1 - 24 months—were translated into Japanese. Forward and backward translations were performed, evaluating the semantic and conceptual equivalencies. Parents with infants younger than two-years-old were recruited and interviewed using think-aloud and probing techniques. Participants completed the questionnaire while speaking aloud about what came to their mind, what they thought each question meant, and how they reached each answer. <strong>Results:</strong> Seven mothers and three fathers participated. The median age was 33.4 (28 - 43) years. Four had infants younger than six-months-old. All infants were healthy. Parents’ perceptions of their infants’ HRQOL varied across their ages. Some parents with infants younger than six months experienced difficulty discussing “emotional functioning” and “cognitive functioning” because their infants were too young to articulate the actions mentioned in the items. In those cases, the parents responded, “never a problem”. Seventy-five percent of parents recalled their infants’ daily “physical functioning”, while only 58% recalled “physical symptoms”. Some parents’ perceptions and judgment formation were compromised by their own perceptions. For example, they answered “often a problem” when the items were problematic to themselves instead of to their child. However, many distinguished their infants’ HRQOL from their own perceptions, indicating they understood the intention of the questionnaire. <strong>Conclusion:</strong> Parents’ formed judgement may compromise by their own perceptions. The result of this study will be helpful in improving healthcare communication and interpreting parents’ judgments of their infants’ HRQOL in future studies.
文摘Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.
基金The research received approval from Children’s Hospital of Shanxi Committee (Approval Number:KLT6230511).
文摘BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both mother and baby.AIM To investigate the relationships between FI and pregnancy outcomes,particularly GDM and PIH,while also examining the mediating role of the dietary diversity score(DDS).METHODS A cross-sectional study was undertaken to examine this relationship,involving 600 pregnant women.Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes.The FI was measured via the Household Food Security Survey Module,with GDM defined as fasting plasma glucose levels of≥5.1 mmol/L or a 2-hour oral glucose tolerance test value of≥8.5 mmol/L.The DDS is determined by evaluating one's food consumption based on nine distinct food groups.A logistic regression model was used to explore the relationship between FI and PIH,and GDM.RESULTS Seventeen percent of participants reported experiencing FI during pregnancy.The study found a significant association between FI and an elevated risk of GDM[odds ratio(OR)=3.32,95%CI:1.2-5.4].Once more,food-insecure pregnant women had higher rates of PIH(OR=0.10,95%CI:0.02-0.45)and they also faced a higher likelihood of neonatal complications,such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight.The FI wasfurther linked to metabolic disruptions,such as elevated fasting blood sugar(FBS),low-density lipoprotein cholesterol,and triglyceride levels.Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM.In particular,the mediation analysis showed that approximately 65%of the effect was mediated through DDS(P=0.002).CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health.Additionally,the study explored how DDS mediates the relationship between FI and the incidence of GDM.
文摘BACKGROUND Human milk oligosaccharides(HMOs)are bioactive components of breast milk with diverse health benefits,including shaping the gut microbiota,modulating the immune system,and protecting against infections.HMOs exhibit dynamic secretion patterns during lactation,influenced by maternal genetics and environ-mental factors.Their direct and indirect antimicrobial properties have garnered significant research interest.However,a comprehensive understanding of the secretion dynamics of HMOs and their correlation with antimicrobial efficacy remains underexplored.AIM To synthesize current evidence on the secretion dynamics of HMOs during lactation and evaluate their antimicrobial roles against bacterial,viral,and protozoal pathogens.METHODS A systematic search of PubMed,Scopus,Web of Science,and Cochrane Library focused on studies investigating natural and synthetic HMOs,their secretion dynamics,and antimicrobial properties.Studies involving human,animal,and in vitro models were included.Data on HMO composition,temporal secretion patterns,and mechanisms of antimicrobial action were extracted.Quality assess-ment was performed using validated tools appropriate for study design.RESULTS A total of 44 studies were included,encompassing human,animal,and in vitro research.HMOs exhibited dynamic secretion patterns,with 2′-fucosyllactose(2′-FL)and lacto-N-tetraose peaking in early lactation and declining over time,while 3-fucosyllactose(3-FL)increased during later stages.HMOs demonstrated significant antimicrobial properties through pathogen adhesion inhibition,biofilm disruption,and enzymatic activity impairment.Synthetic HMOs,including bioengineered 2′-FL and 3-FL,were structurally and functionally comparable to natural HMOs,effectively inhibiting pathogens such as Pseudomonas aeruginosa,Escherichia coli,and Campylobacter jejuni.Additionally,HMOs exhibited synergistic effects with antibiotics,enhancing their efficacy against resistant pathogens.CONCLUSION HMOs are vital in antimicrobial defense,supporting infant health by targeting various pathogens.Both natural and synthetic HMOs hold significant potential for therapeutic applications,particularly in infant nutrition and as adjuncts to antibiotics.Further research,including clinical trials,is essential to address gaps in knowledge,validate findings,and explore the broader applicability of HMOs in improving maternal and neonatal health.
文摘Taking into account the hierarchical structure of the data, through two-level analysis on infant mortality available under second round of National family Health Survey, the same group of authors recently reported determinants of infant mortality while examining possible changes in results under traditional regression analysis that ignores hierarchical structure of data. They reported that the community (e.g., state) level characteristics still have a major role regarding infant mortality in India. For better epidemiological understanding, the present study is to assess determinants of infant mortality in rural India, where three level considerations were possible. The results indicate that even after consideration of these covariates, variation in infant mortality remains significant not only between States but also between Districts. Further, as an additional observation, the probability of infant mortality is still high in rural areas of districts having health facility beyond three kilometers than their counterparts.
文摘目的探讨早产儿出生时血清类胡萝卜素水平与其健康状况之间的相关性。方法回顾性分析2021年7月至2023年7月在赣州市人民医院新生儿科接受治疗的11名出生胎龄<37周早产儿的临床资料。收集早产儿的基础信息(如性别、胎龄、体质量、Apgar评分等)及血清类胡萝卜素水平。分析早产儿血清类胡萝卜素水平,采用Spearman相关分析早产儿血清类胡萝卜素与Apgar评分的相关性,并比较血清类胡萝卜素不同浓度早产儿的Apgar评分。结果11名早产儿中男性5名(45.5%),女性6名(54.5%);出生胎龄31.3~35.7周,平均(34.0±1.7)周;出生体质量1100~2200 g,平均(1905.5±827.8)g;1 min Apgar评分6~10分,平均(9±1.3)分,5 min Apgar评分8~10分,平均(9.8±0.6)分。早产儿的血清叶黄素、玉米黄质和β-隐黄质的中位水平分别为0.098 g/m L,0.042 g/m L和0.40 g/m L;Spearman相关分析结果显示,早产儿的血清叶黄素类胡萝卜素水平与1 min Apgar评分及5 min Apgar评分均无相关性(P>0.05);血清高浓度叶黄素组和玉米黄质组早产儿的1 min Apgar评分明显高于低浓度组,差异均有统计学意义(P<0.05),但高低浓度β-隐黄质组的早产儿的1 min Apgar评分比较差异无统计学意义(P>0.05)。结论本研究未能发现早产儿血清类胡萝卜素水平与Apgar评分之间的相关性。然而,高浓度叶黄素和玉米黄质可能对早产儿的短期健康状况(如Apgar评分)有积极影响。因此,在早产儿的护理中,关注血清类胡萝卜素的水平可能具有重要的临床意义。
