Nursing, its duration and its outcomes for mother and child.
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401 to 425 of 480A study of early complementary feeding determinants in the Republic of Ireland based on a cross-sectional analysis of the Growing Up in Ireland infant cohort.
Objective: Early complementary feeding has been shown to increase the risk of overweight, obesity and chronic diseases later in life. Poor compliance with current guidelines on complementary feeding has been reported by Irish studies. The aim of the present paper is to identify predictors of early complementary feeding in order to help health professionals target population groups in greater need of dietary intervention as well as to provide effective advice.
Design: Cross-sectional analysis of the national, longitudinal Growing Up in Ireland study.
Setting: Data were derived from the first wave (2007-2008) of the Growing Up in Ireland infant cohort.
Subjects: A cohort of mothers (n 11 134) from the Republic of Ireland, interviewed when their infants were 9 months of age.
Results: Of the infants, 1469 (13·5 %) had been regularly taking solids in the period between 12 and 16 weeks; this p…
matched on Infant Nutritional Physiological Phenomena (mesh)
Depression, anxiety, and perinatal-specific posttraumatic distress in mothers of very low birth weight infants in the neonatal intensive care unit.
Objective: To compare the trajectories and determine the predictors of maternal distress defined as a continuous spectrum of symptomatology and elevated symptomatology, of depression, anxiety, and perinatal-specific posttraumatic stress (PPTS), in mothers of very low birth weight (VLBW) infants throughout the neonatal intensive care unit (NICU) hospitalization.
Method: Sixty-nine mothers completed psychological questionnaires within the first month of their infant's NICU hospitalization and again 2 weeks before NICU discharge. Multiple regression models determined maternal psychological, reproductive, sociodemographic, and infant medical predictors of maternal distress.
Results: Perinatal-specific posttraumatic stress remained stable throughout the NICU hospitalization, whereas other aspects of distress declined. Previous psychological history and infant medical variables predicted highe…
matched on Intensive Care Units, Neonatal (mesh), Infant, Newborn (mesh)
Perinatal and juvenile social environments interact to shape cognitive behaviour and neural phenotype in prairie voles.
Social environments experienced at different developmental stages profoundly shape adult behavioural and neural phenotypes, and may have important interactive effects. We asked if social experience before and after weaning influenced adult social cognition in male prairie voles. Animals were raised either with or without fathers and then either housed singly or in sibling pairs. Males that were socially deprived before (fatherless) and after (singly housed) weaning did not demonstrate social recognition or dissociate spatial from social information. We also examined oxytocin and vasopressin receptors (OTR and V1aR) in areas of the forebrain associated with social behaviour and memory. Pre- and post-wean experience differentially altered receptor expression in several structures. Of note, OTR in the lateral septum-an area in which oxytocin inhibits social recognition-was greatest in anima…
matched on Weaning (mesh)
Risk factors for postpartum depressive symptoms in low-income women with very low-birth-weight infants.
Purpose: This study examined factors associated with postpartum depressive symptoms in mothers with premature infants in the neonatal intensive care unit (NICU).
Subjects: A total of 113 new mothers with very low-birth-weight infants in their initial NICU admission were recruited from 2 urban hospitals servicing low-income minority communities.
Design: This study employed a cross-sectional design.
Methods: Data were collected during the infants' postpartum NICU admission and included maternal demographic information (eg, age, education, race, living with the baby's father), infant illness severity (Neurobiologic Risk Score from infant's medical record), and maternal psychological measures (the Center for Epidemiologic Studies Depression Scale, the Perinatal Posttraumatic Stress Questionnaire, and the State-Trait Anxiety Inventory).
Results: The findings indicated that 47 (42%) women had …
matched on Intensive Care Units, Neonatal (mesh), Infant, Newborn (mesh)
Health care utilisation in the first year of life among infants of mothers with perinatal depression or anxiety.
Background: Limited information is available on associations between maternal depression and anxiety and infant health care utilisation.
Methods: We analysed data from 24 263 infants born between 1998 and 2007 who themselves and their mothers were continuously enrolled for the infant's first year in Kaiser Permanente Northwest. We used maternal depression and anxiety diagnoses during pregnancy and postpartum to categorise infants into two depression and anxiety groups and examined effect modification by timing of diagnosis (pregnancy only, postpartum only, pregnancy and postpartum). Using generalised estimating equations in multivariable log-linear regression, we estimated adjusted risk ratios (RR) between maternal depression and anxiety and well baby visits (<5 and ≥ 5), up to date immunisations (yes/no), sick/emergency visits (<6 and ≥ 6) and infant hospitalisation (any/none).
Results:…
matched on Infant Care (mesh), Postpartum Period (mesh)
The experiences of NICU nurses in caring for infants with neonatal abstinence syndrome.
Purpose: This study explored the experiences of NICU nurses in caring for infants with neonatal abstinence syndrome (NAS).
Design: A qualitative research approach was used with open-ended questions employing computer-assisted personal interviews.
Sample: Fourteen NICU nurses employed in a regional hospital provided responses.
Results: The nurses reflected a personal struggle between a desire to employ their technical and critical nursing skills and the need to provide expected maternal care to NAS infants. Other themes included frustration and burnout, challenges to values about parenting, and increased awareness of drug use in the community and at home.
Discussion: The results suggest that nurses underrate the skill required to care for infants with NAS. The level of knowledge, patience, and commitment to these newborns should be reframed to increase job satisfaction, and education shou…
matched on Intensive Care Units, Neonatal (mesh), Infant, Newborn (mesh)
Categorizing neonatal deaths: a cross-cultural study in the United States, Canada, and The Netherlands.
Objective: To clarify the process of end-of-life decision-making in culturally different neonatal intensive care units (NICUs).
Study design: Review of medical files of newborns >22 weeks gestation who died in the delivery room (DR) or the NICU during 12 months in 4 NICUs (Chicago, Milwaukee, Montreal, and Groningen). We categorized deaths using a 2-by-2 matrix and determined whether mechanical ventilation was withdrawn/withheld and whether the child was dying despite ventilation or physiologically stable but extubated for neurological prognosis.
Results: Most unstable patients in all units died in their parents' arms after mechanical ventilation was withdrawn. In Milwaukee, Montreal, and Groningen, 4% to 12% of patients died while receiving cardiopulmonary resuscitation. This proportion was higher in Chicago (31%). Elective extubation for quality-of-life reasons never occurred in Chicag…
matched on Intensive Care Units, Neonatal (mesh), Infant, Newborn (mesh)
Stillbirth: the mother's experience and implications for improving care.
More children die as a result of stillbirth than all other causes of infant deaths combined (Ananth, Shiliang, Kinzler, and Kramer, 2005; Goldenberg, Kirby, and Culhane, 2004; Froen, 2005; National Institute of Health, 2004); yet, mothers experiencing stillbirth are often left without support afterwards (Kubler-Ross, 2004; Fahey-McCarthy, 2003; Fletcher 2002; Saddler, 1987; DeFrain, 1986; Kirkley-Best & Kellner, 1982). Despite social work's growing involvement in care at the end of life, parents of stillborn children have not experienced consistent, relevant, and competent professional care in coping with the tragedy of death. Forty-seven women between the ages of 19 and 51 were recruited through nonprofit agencies that provide bereavement care to grieving families. Results of this qualitative study suggest that stillbirth is emotionally complex with long-lasting symptoms of grief and si…
matched on Infant Care (mesh), Infant, Newborn (mesh)
Putting woman-centered care into practice: a new (ANEW) approach to psychosocial risk assessment during pregnancy.
Background: When antenatal care is provided, identification and management of challenging problems, such as depression, domestic violence, child abuse, and substance abuse, are absent from traditional midwifery and medical training. The main objective of this project was to provide an alternative to psychosocial risk screening in pregnancy by offering a training program (ANEW) in advanced communication skills and common psychosocial issues to midwives and doctors, with the aim of improving identification and support of women with psychosocial issues in pregnancy.
Methods: ANEW used a before-and-after survey design to evaluate the effects of a 6-month educational intervention for health professionals. The setting for the project was the Mercy Hospital for Women in Melbourne, Australia. Surveys covered issues, such as perceived competency and comfort in dealing with specific psychosocial i…
matched on Infant Care (mesh), Infant, Newborn (mesh)
Identification of Modifiable Social and Behavioral Factors Associated With Childhood Cognitive Performance.
Importance: Inequities in social environments are likely associated with a large portion of racial disparities in childhood cognitive performance. Identification of the specific exposures associated with cognitive development is needed to inform prevention efforts.
Objective: To identify modifiable factors associated with childhood cognitive performance.
Design, setting, and participants: This longitudinal pregnancy cohort study included 1503 mother-child dyads who were enrolled in the University of Tennessee Health Science Center-Conditions Affecting Neurodevelopment and Learning in Early Life study between December 1, 2006, and July 31, 2011, and assessed annually until the children were aged 4 to 6 years. The analytic sample comprised 1055 mother-child dyads. A total of 155 prenatal, perinatal, and postnatal exposures were included to evaluate environment-wide associations. Participan…
matched on breastfeeding (text), Infant, Newborn (mesh)
Comorbid anxiety and depression: a community-based study examining symptomology and correlates during the postpartum period.
Background: Despite indications that anxiety and depression co-occur frequently within the postpartum period, studies identifying the correlates associated with this comorbidity are rare. Objective: This study assessed variation in social and maternal circumstances, based on comorbid anxiety and depression symptomology. Methods: A large community-based sample of 1070 Australian postpartum women completed the Living with a Young Baby online survey. Mothers were categorised into groups: (a) comorbid anxiety and depression symptomology, (b) anxiety only, (c) depression only, or (d) neither depression nor anxiety. Multinomial Logistic Regression (MLR) investigated variation in correlates between the groups. Results: Comorbid anxiety and depression symptomology was common (13.4%), and was associated with greater symptom severity. Women in the 'comorbid' group more often experienced financial …
matched on breastfeeding (text), Postpartum Period (mesh)
Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health.
Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child's neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Calories are essential for growth of both fetus and child but are not sufficient for normal brain development. Although all nutrients are necessary for brain growth, key nutrients that support neurodevelopment include protein; zinc; iron; choline; folate; iodine; vitamins A, D, B6, and B12; and long-chain polyunsaturated fatty acids. Failure to provide key nutrients during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion. Understanding the complex interplay of micro- and macronutrients and neurodevelopme…
matched on breastfeeding (text), Infant, Newborn (mesh)
Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis.
Background: Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0-23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria.
Methods: The sample included 24,529 children aged 0-59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz < -2SD) and severe stunting (HFAz < -3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria.
Re…
matched on breastfeeding (text), Infant, Newborn (mesh)
Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention.
Background/objectives: Pregnancy triggers a physiological change in weight status. Postpartum weight retention in the childbearing years can substantially alter a woman's weight gain trajectory, with several potential contributing factors identified. Most research has relied on women's recall of pre-pregnancy weight during pregnancy or later, and not considered risk factors in combination. Using measured pre-pregnancy weight, this study aimed to examine the associations of maternal postpartum weight retention with parity, pre-pregnancy BMI, excessive gestational weight gain (GWG), maternal serum vitamin D concentration and dietary Glycaemic Index in early and late pregnancy, and breastfeeding duration, including analysis of the combined impact of potentially modifiable risk factors.
Subjects/methods: Prospective cohort study of 12 583 non-pregnant women aged 20-34 years in Southampton (U…
matched on breastfeeding (text), Postpartum Period (mesh)
Fall CH, Sachdev HS, Osmond C, Restrepo-Mendez MC, Victora C, Martorell R, Stein AD, Stein AD, Sinha S, Tandon N, Adair L, Bas I, Norris S, Richter LM, COHORTS investigators (2015)MEDLINE-indexed journal, not yet read by usThe Lancet. Global health316 citations Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration).
Background: Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries (LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs.
Methods: In this prospective study, we pooled data from COHORTS (Consortium for Health Orientated Research in Transitioning Societies)-a collaboration of five birth cohorts from LMICs (Brazil, Guatemala, India, the Philippines, and South Africa), in which mothers were recruited before or during pregnancy, and the children followed up to adulthood. We examined associations between maternal age and offspring birthweight, gestational age at birth, height-for-age and weight-for-height Z scores in childhood, attained schooling, and adult height, body composition (body-mass index, w…
matched on breastfeeding (text), Infant, Newborn (mesh)
Maternal tobacco smoking in pregnancy and children's socio-emotional development at age 5: The EDEN mother-child birth cohort study.
Background: There is debate as to whether maternal tobacco use in pregnancy is related to offspring behaviour later on. We tested this association examining multiple aspects of children's behaviour at age 5 and accounting for parental smoking outside of pregnancy, as well as child and family characteristics.
Methods: Data come from a prospective community based birth cohort study (EDEN; n=1113 families in France followed since pregnancy in 2003-2005 until the child's 5th birthday). Maternal tobacco use in pregnancy was self-reported. Children's socio-emotional development (emotional symptoms, conduct problems, symptoms of hyperactivity/inattention, peer relationship problems, prosocial behaviour) was assessed by mothers using the Strengths and Difficulties Questionnaire (SDQ) at age 5 years. Logistic regression analyses controlled for Inverse Probability Weights (IPW) of maternal tobacco…
matched on breastfeeding (text), Infant, Newborn (mesh)
Incorporating recognition and management of perinatal and postpartum depression into pediatric practice.
Every year, more than 400,000 infants are born to mothers who are depressed, which makes perinatal depression the most underdiagnosed obstetric complication in America. Postpartum depression leads to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development. Pediatric practices, as medical homes, can establish a system to implement postpartum depression screening and to identify and use community resources for the treatment and referral of the depressed mother and support for the mother-child (dyad) relationship. This system would have a positive effect on the health and well-being of the infant and family. State chapters of the American Academy of Pediatrics, working with state Early Periodic Screening, Diagnosis, and Treatment (EPSDT) and maternal and child…
matched on breastfeeding (text), Infant, Newborn (mesh)
Community violence and urban childhood asthma: a multilevel analysis.
We examined the association between community violence exposure and childhood asthma risk in a multilevel, multimethod, longitudinal study controlling for individual- and neighbourhood-level confounders and pathway variables. Analyses included 2,071 children aged 0-9 yrs at enrolment from the Project on Human Development in Chicago Neighborhoods. Multilevel logistic regression models estimated the likelihood of asthma, controlling for individual-level (child's age, sex, race/ethnicity, maternal asthma, socioeconomic status and family violence in the home) and neighbourhood-level confounders (concentrated disadvantage, collective efficacy and social disorder), and pathway variables (maternal smoking, breastfeeding). In adjusted analyses, medium (OR 1.60, 95% CI 1.17-2.19) and high levels (OR 1.56, 95% CI 1.12-2.18) of community violence were associated with increased asthma risk, relative…
matched on breastfeeding (text), Infant, Newborn (mesh)
Barriers to postpartum health and opinions on a postpartum peer navigator program amongst refugee women resettled in California.
Background: The aim of this study is to identify postpartum challenges and assess for interest in a postpartum peer navigator program amongst refugee women resettled in California.
Methods: Participants were recruited through ethnic community-based organizations in California using convenience and snowball sampling. Arabic, Dari, or Pashto speaking women who have given birth in the United States within the last five years and entered the country as refugees, special immigrant visa holders, or asylum seekers were eligible to participate. Semi-structured interviews were analyzed using Braun and Clarke's thematic analysis.
Results: We interviewed 26 participants. The mean age was 30 years (SD = 6.3) and mean length of time in the United States was 4.5 years (SD = 3.0). All participants are state insurance recipients. Most participants (89%, n = 23) utilize an interpreter. We identified seve…
matched on Postnatal Care (mesh), Postpartum Period (mesh)
Mavioglu RN, Gumpp AM, Hummel EM, Moser DA, Ammerpohl O, Behnke A, Mack M, Kolassa IT (2025)MEDLINE-indexed journal, not yet read by usBrain, behavior, and immunity2 citations Telomere-mitochondrial dynamics differ depending on childhood maltreatment history, catabolic postpartum state, and developmental period.
Telomere attrition, a hallmark of aging, is linked to high-energy demand states like early development and biological or psychological stress. Metabolic regulation of telomere length (TL) may occur in these states as part of an energetic trade-off, prioritizing immediate needs over long-term requirements such as telomere maintenance, though this has not been observed in healthy humans. We examined associations between TL and mitochondrial bioenergetics, density, and DNA markers in immune cells of women at 1-week (n = 175) and 1-year postpartum (n = 106), depending on their history of childhood maltreatment (CM), and in their newborns (n = 132). At 1-week postpartum, a catabolic state of high energy demand, women with lower mitochondrial energy production efficiency exhibited shorter TL. One year later, these dynamics appeared only in women with a history of CM. In newborns, TL was shorte…
matched on Infant, Newborn (mesh), Postpartum Period (mesh)
Factors influencing participation in home, school, and community settings by 6- to 9-year-old children born preterm: a qualitative descriptive study.
Purpose: There is no published information on preterm children's activities and participation during middle childhood, a time when growth and development are characterised by increasing motor, reasoning, self-regulation, social and executive functioning skills. This study explored the health, activities and participation of children born very preterm during middle childhood (6-9 years) from the perspectives of their parents.
Methods: This was a qualitative descriptive design. Twenty parents of 27 very preterm children born < 32 weeks gestation participated in semi-structured interviews to explore their child's health, behaviour, functioning and participation in school, at home and in the community along with environment and personal factors that influenced the child's activities and participation. Interview data were coded to each of the International Classification of Functioning in Dis…
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
A Protocol to Assess Adult Outcomes at 30 Years Following Preterm Birth.
Background: Among the most intense adversity experiences for infants is premature birth. Early birth marks the beginning of a life course that broadly affects families, healthcare, education, social systems, and the survivors themselves. For many, the transition to adulthood is challenging and often hampered by cognitive, physical and mental health, and motor and independence difficulties.
Objectives: The aim of this study was to share a comprehensive protocol of a 10th follow-up study of premature infants in their 30s. The protocol accounts for stress during the neonatal period, the cumulative context (risk and protection) of development, biological and epigenetic mechanisms, and individual resilience.
Methods: The prospective, five-group longitudinal design includes 215 term-born and preterm-born individuals with various neonatal morbidities at ages 30-35 years. Adult outcomes include …
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
Paternal symptoms of anxiety and depression in the first month after childbirth: A comparison between fathers of full term and preterm infants.
Background: Although men have a higher risk of developing a mental disorder during the perinatal period, few studies have focused on new fathers' mental health screening. This study compares anxiety and depression symptoms between fathers with newborn infants in the neonatal intensive care unit (NICU) and fathers of healthy full-term infants, assessing the impact of stress caused by the NICU..
Methods: A longitudinal and prospective study with control (n= 33) and study groups (n=51) was designed. The dependent variables assessed were post-natal depression and anxiety-state while the social and demographic information, health background and the parental stress in the neonatal unit were the independent variables. The fathers were assessed twice during the first month after birth.
Results: Significant differences in the EPDS scores were found between both groups in the first assessment (p =…
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
The perinatal bereavement project: development and evaluation of supportive guidelines for families experiencing stillbirth and neonatal death in Southeast Brazil-a quasi-experimental before-and-after study.
Background: For most parents, getting pregnant means having a child. Generally, the couple outlines plans and has expectations regarding the baby. When these plans are interrupted because of a perinatal loss, it turns out to be a traumatic experience for the family. Validating the grief of these losses has been a challenge to Brazilian society, which is evident considering the childbirth care offered to bereaved families in maternity wards. Positively assessed care that brings physical and emotional memories about the baby has a positive impact on the bereavement process that family undergoes. Therefore, this study aims to assess the effects supportive guidelines have on mental health. They were designed to assist grieving parents and their families while undergoing perinatal loss in public maternities in Ribeirão Preto, São Paulo state, Brazil.
Method: A mixed-methods (qualitative/quant…
matched on Infant, Newborn (mesh), Postnatal Care (mesh)
Postnatal care service utilization and its determinants in East Gojjam Zone, Northwest Ethiopia: A mixed-method study.
Background: The days and weeks after childbirth are crucial for both the mother and her newborn child leading for the majority of maternal and perinatal mortalities. The World Health Organization recommends at least three postnatal visits within 42 days after birth. However, postnatal care utilization remains low worldwide. Quantitative findings revealed low utilization of postnatal care in Ethiopia, however, no study explored the barriers for postnatal care. This study aimed to assess the barriers to postnatal care service utilization in East Gojjam Zone, Northwest Ethiopia.
Methods: A community-based, mixed type cross-sectional study was conducted from December 15, 2018, to February 15, 2019. The quantitative data was gathered using the interviewer-administered interviewing technique from 751 women who gave birth within one year prior to the study selected by multistage sampling. The q…
matched on Infant, Newborn (mesh), Postnatal Care (mesh)