Early life risk exposure and stunting in urban South African 2-year old children

2017 ◽  
Vol 8 (3) ◽  
pp. 301-310 ◽  
Author(s):  
W. Slemming ◽  
J. Kagura ◽  
H. Saloojee ◽  
L. M. Richter
Keyword(s):  
Birth Weight ◽  
South African ◽  
Odds Ratio ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Health Concern ◽  
Risk Exposure ◽  
Birth Cohort Study ◽  
Mortality And Morbidity ◽  
Urban South

Stunting is a measure of overall nutritional status and is a major public health concern because of its association with child mortality and morbidity and later adult performance. This study examined the effects of pregnancy events, birth characteristics and infant risk exposure on stunting at age 2 years. The study, established in 1990 in Soweto, an urban South African township, included 1098 mother–infant pairs enroled in the Birth to Twenty Plus longitudinal birth cohort study. In total, 22% of children were stunted at age 2 years, with males at greater risk than females [24.8 v. 19.4%, odds ratio (OR)=1.38; 95% confidence interval (CI): 1.03, 1.83]. In unadjusted analysis, male sex, household socio-economic status (SES), overcrowding, maternal age, maternal education, single motherhood, ethnicity, birth weight, gestational age and duration of infant breastfeeding were all significantly associated with stunting. In multivariable analysis, higher birth weight was protective against stunting for both sexes. Higher maternal education was protective for females only (adjusted odds ratio (AOR)=0.35; 95% CI: 0.14, 0.87), whereas wealthier household SES protected males (AOR for richest SES group=0.39; 95% CI: 0.16, 0.92). In this and other similar settings, current stunting prevention efforts focussing on primarily providing targeted proximal interventions, such as food supplements, risk undermining the critical importance of addressing key distal determinants of stunting such as SES and maternal education.

scholarly journals Factors associated with low birth weight in Afghanistan: a cross-sectional analysis of the demographic and health survey 2015

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025715 ◽  
Author(s):  
Rajat Das Gupta ◽  
Krystal Swasey ◽  
Vanessa Burrowes ◽  
Mohammad Rashidul Hashan ◽  
Gulam Muhammed Al Kibria
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Urban Areas ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Demographic And Health Survey ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Factors Associated

ObjectivesThis study aimed to investigate the factors associated with low birth weight (LBW) in Afghanistan.DesignCross-sectional study.SettingThis study used data collected from the Afghanistan Demographic and Health Survey 2015.ParticipantsFacility-based data from 2773 weighted live-born children enrolled by a two-stage sampling strategy were included in our analysis.Primary and secondary outcome measuresThe primary outcome was LBW, defined as birth weight <2.5kg.ResultsOut of 2773 newborns, 15.5% (n=431) had LBW. Most of these newborns were females (58.3%, n=251), had a mother with no formal schooling (70.5%, n=304), lived in urban areas (63.4%, n=274) or lived in the Central region of Afghanistan (59.7%, n=257). In multivariable analysis, residence in Central (adjusted OR (AOR): 3.4; 95% CI 1.7 to 6.7), Central Western (AOR: 3.0; 95% CI 1.5 to 5.8) and Southern Western (AOR: 4.0; 95% CI 1.7 to 9.1) regions had positive association with LBW. On the other hand, male children (AOR: 0.5; 95% CI 0.4 to 0.8), newborns with primary maternal education (AOR: 0.5; 95% CI 0.3 to 0.8), birth interval ≥48 months (AOR: 0.4; 95% CI 0.1 to 0.8), belonging to the richest wealth quintile (AOR: 0.2; 95% CI 0.1 to 0.6) and rural residence (AOR: 0.3; 95% CI 0.2 to 0.6) had decreased odds of LBW.ConclusionsMultiple factors had association with LBW in Afghanistan. Maternal, Neonatal and Child Health programmes should focus on enhancing maternal education and promoting birth spacing to prevent LBW. To reduce the overall burden of LBW, women of the poorest wealth quintiles, and residents of Central, Central Western and South Western regions should also be prioritised. Further exploration is needed to understand why urban areas are associated with higher likelihood of LBW. In addition, research using nationally representative samples are required.

scholarly journals SickKids Centre for Global Child Health - Chronic Child Malnutrition Project Placement

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Zahra Hussain
Keyword(s):  
Child Health ◽  
Motor Development ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Household Wealth ◽  
Acute Malnutrition ◽  
Child Malnutrition ◽  
Global Health Research ◽  
Access To Health Services ◽  
Mortality And Morbidity

I completed a 16-week practicum at the SickKids Centre for Global Child Health where I was a part of the stunting team led by Dr. Nadia Akseer under the research portfolio of Dr. Zulfiqar A. Bhutta. Linear growth stunting, or low height-for-age, is a visible and easily measurable physical manifestation of chronic malnutrition. Children who are stunted have higher rates of mortality and morbidity, as well as experience suboptimal cognitive and motor development. At the time of my placement, one of the team's main projects was a mixed-methods study involving an in-depth evaluation of policies, programs, and factors that have contributed to the decline of under-5 stunting in Ethiopia from 2000-2016. I worked on a variety of components of the manuscript for this study. These included narratives for country demographics, background statistics as well as migration and remittance trends. I also contributed to a literature review on factors that have contributed to a reduction in stunting in Ethiopia in relation to an adapted version of UNICEF's conceptual framework for malnutrition. In addition to the manuscript, I conducted a multivariable analysis of the 2016 determinants of under-5 wasting in Ethiopia. Wasting, or low weight for height, is a form of acute malnutrition and is also a risk factor for mortality. I applied a hierarchical analysis to wasting indicators such as disease, household wealth, maternal education and access to health services. I used Ethiopia's 2016 Demographic and Health Survey data and additional data sources provided through various Ethiopian government ministries. Overall my practicum was a rich interdisciplinary learning experience which allowed me to develop my quantitative and qualitative research skills. I also gained a deeper understanding of global health research processes and the multi-sectoral nature of combating child malnutrition.

scholarly journals TO DETERMINE THE FREQUENCY OF FETAL COMPLICATIONS IN PRETERM LABOR

1969 ◽  
Vol 6 (2) ◽  
pp. 832-836
Author(s):  
MAIMOONA QADIR ◽  
SOHAIL AMIR ◽  
AMIKA KUMARI
Keyword(s):  
Birth Weight ◽  
Sample Size ◽  
Preterm Labor ◽  
Birth Asphyxia ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Physical Burden ◽  
Fetal Complications

BACKGROUND: Preterm birth is the major cause of perinatal mortality and morbidity and animportant public health concern. Keeping in view the complications involved, preterm babies are asource of financial, psychological and physical burden on their families.OBJECTIVE: To determine the frequency of fetal complications in preterm labor.MATERIALS AND METHODS: This descriptive (cross sectional) study was conducted atDepartment of Gynaecology and Obstetrics, Khyber Teaching Hospital, Peshawar from August 2015 toJanuary 2016.Sample size was 147,using 10.7% proportion of birth asphyxia,95% confidence intervaland 5% margin of error, under WHO software for sample size calculation.RESULTS: In this study mean maternal age was 30years with standard deviation + 1.63.Frequency oflow birth weight was analyzed as 113(77%),birth asphyxia was found in 34(23%) patients, hypothermiawas found in 90(61%) and hypoglycemia in 71(48%) patients.CONCLUSION: All the four parameters (Birth weight, hypothermia ,hypoglycemia, birth asphyxia)were found to be significantly effected by the gestational age at which the baby was born.The lower thegestational age,the worst is the outcome and vice versa.KEY WORDS: Preterm labor, fetal complications, birth asphyxia .hypothermia .hypoglycemia.

scholarly journals Association between maternal antenatal care visits and newborn low birth weight in Bangladesh: a national representative survey

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 935
Author(s):  
Md. Sabbir Ahmed ◽  
Sumaia Sahrin ◽  
Fakir Md Yunus
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antenatal Care ◽  
Weight Status ◽  
Maternal Education ◽  
Childhood Mortality ◽  
Health Concern ◽  
Maternal Weight ◽  
Cross Sectional ◽  
Antenatal Services

Background: Low Birth Weight (LBW) is a global health concern for childhood mortality and morbidity. The objectives of this study were to assess the association between the number of Antenatal Care Visits (ANC) and LBW among Bangladeshi newborns, and to identify the demographic and socio-economic predictors of LBW.   Methods: Our present cross-sectional study is based on the secondary data of the Bangladesh Demography and Health Survey (BDHS) 2014. Complete data of 4,235 (weighted) mother-child pairs were included in the analysis.   Results: The overall prevalence of LBW among newborns were found to be 19.3% (95% CI: 17.8-20.9). Among the mothers who received antenatal care services 1-3 times during pregnancy, 35% had less possibility of having LBW babies [COR = 0.65, 95% CI: 0.50-0.85]. The association remained significant after adjusting the analysis with the sex of the newborn, administrative regions (division), maternal educational status, mother’s weight status and fathers’ occupation [AOR = 0.74, 95% CI: 0.55-0.99]. Additionally, the sex of the newborn, division, maternal education, maternal weight status, and fathers’ occupational status were found to be significantly associated with LBW.   Conclusion: Increasing the coverage of antenatal services and enabling mothers to receive quality antenatal services may substantially contribute to reducing the prevalence of LBW in Bangladesh.

scholarly journals Estimating the pathways through which maternal education affects stunting: evidence from an urban cohort in South Africa

2018 ◽  
Vol 21 (10) ◽  
pp. 1810-1818 ◽  
Author(s):  
Daniela Casale ◽  
Gabriel Espi ◽  
Shane A Norris
Keyword(s):  
South Africa ◽  
Cohort Study ◽  
Birth Weight ◽  
Birth Cohort ◽  
Maternal Education ◽  
Economic Status ◽  
Quality Care ◽  
Final Analysis ◽  
Outcome Variable ◽  
Birth Cohort Study

AbstractObjectiveTo estimate the determinants of stunting using rich data from a birth cohort study from urban South Africa and to examine the various mechanisms, both proximate and distal, through which maternal education affects stunting.DesignMultivariate regression analysis using birth cohort data, where the outcome variable was stunting at age 2 years, and multiple mediator analysis to identify pathways from maternal education to stunting.SettingSouth Africa’s largest metropolitan area, Soweto-Johannesburg.SubjectsParticipants of Birth to Twenty Plus, a longitudinal cohort study of children born in 1990 (n 691).ResultsIn multivariate analysis, the birth weight Z-score (−0·084; P<0·001; 95 % CI −0·11, −0·06), the mother’s openness towards modern health care, captured by a vaccination score (−0·05; P=0·04; 95 % CI −0·10, −0·00), and a better-quality care environment (−0·015; P=0·04; 95 % CI −0·03, −0·00) were found to be negatively associated with stunting. Having experienced symptoms of illness related to ears and eyes increased the risk of stunting (0·038; P=0·01; 95 % CI 0·01, 0·07). Results of the mediation analysis showed that maternal education had an indirect effect on stunting largely through socio-economic status and the antenatal environment (measured by the birth weight Z-score).ConclusionsOverall, many of the factors that were protective against stunting in the final analysis, whether they operated through maternal education or not, were related to the mother’s contribution to the child’s life. This reinforces the idea that to minimise stunting, enhanced antenatal and postnatal services to better support and empower mothers may be important.

Discrepancy Analysis between Clinical Versus Ultrasound Estimated Fetal Weight and Actual Birth Weight at 3rd Trimester

2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fetal Weight ◽  
P Value ◽  
Weight Estimation ◽  
Third Trimester ◽  
Mortality And Morbidity ◽  
Fetal Weight Estimation ◽  
Obstetric Management ◽  
Estimated Fetal Weight

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38

scholarly journals Influence of vitamin D serum concentration, prenatal care and social determinants on birth weight: a northeastern Brazilian cohort study

2019 ◽  
Vol 122 (03) ◽  
pp. 284-292 ◽  
Author(s):  
Marcos Pereira-Santos ◽  
Gisele Queiroz Carvalho ◽  
Djanilson Barbosa dos Santos ◽  
Ana Marlucia Oliveira
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Prenatal Care ◽  
Serum Concentration ◽  
Pregnant Women ◽  
Social Determinants ◽  
Maternal Education ◽  
Late Onset ◽  
High Birth Weight ◽  
Maternal Vitamin

AbstractThe relationship among social determinants, vitamin D serum concentration and the health and nutrition conditions is an important issue in the healthcare of pregnant women and newborns. Thus, the present study analyses how vitamin D, prenatal monitoring and social determinants are associated with birth weight. The cohort comprised 329 pregnant women, up to 34 weeks gestational age at the time of admission, who were receiving care through the prenatal services of Family Health Units. Structural equation modelling was used in the statistical analysis. The mean birth weight was 3340 (sd 0·545) g. Each nmol increase in maternal vitamin D serum concentration was associated with an increase in birth weight of 3·06 g. Prenatal healthcare with fewer appointments (β −41·49 g, 95 % CI −79·27, −3·71) and late onset of care in the second trimester or third trimester (β −39·24 g, 95 % CI −73·31, −5·16) favoured decreased birth weight. In addition, low socio-economic class and the practice of Afro-Brazilian religions showed a direct association with high vitamin D serum concentrations and an indirect association with high birth weight, respectively. High gestational BMI (β 23·84, 95 % CI 4·37, 43·31), maternal education level (β 24·52 g, 95 % CI 1·82, 47·23) and length of gestation (β 79·71, 95 % CI 52·81; 106·6) resulted in high birth weight. In conclusion, maternal vitamin D serum concentration, social determinants and prenatal care, evaluated in the context of primary healthcare, directly determined birth weight.

scholarly journals Examining the Role of Acculturation in E-Cigarette Use among U.S. Immigrant Adults

2021 ◽  
Vol 18 (7) ◽  
pp. 3658
Author(s):  
Sunday Azagba ◽  
Lingpeng Shan
Keyword(s):  
Host Country ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Population Data ◽  
Cultural Norms ◽  
Cigarette Use ◽  
Length Of Residence ◽  
Native Populations ◽  
The U.S

Evidence suggests that as immigrants’ length of residence in the host country increases, they may integrate their behavior and norms to align with the new community’s cultural norms. The current study examined e-cigarette use among immigrants in the U.S., and whether the length of residence in the U.S. is associated with e-cigarette use among immigrants compared to the native-born population. Data were drawn from the 2014/15 and 2018/19 Tobacco Use Supplement to the Current Population Survey. Multivariable logistic regression was used to compare differences in e-cigarette use between native-born populations and immigrants, when immigrants’ length of residence in the U.S. was considered. Among immigrants, the prevalence of ever and current e-cigarette use increased significantly from 2.5% and 0.5% in 2014/2015 to 3.2% and 0.8% in 2018/2019, respectively. Multivariable analysis showed that immigrants had significantly lower odds of ever e-cigarette use compared to the mainland-born citizen (0–5 years in the U.S., adjusted Odds Ratio (aOR) 0.57, 95% Confidence Interval (CI) 0.46–0.69; 6–10 years, aOR 0.51, 95% CI 0.41–0.63; 11–20 years, aOR 0.45, 95% CI 0.39–0.53; 20+years, aOR 0.68, 95% CI 0.62–0.76). Similar results were found for current e-cigarette use, with immigrants being less likely to be current users. Findings that e-cigarette use among all immigrants—regardless of years living in the U.S.—was consistently lower than among the native-born population run contrary to the notion that as length of stay increases, health behaviors between immigrants and native populations of the host country become similar.

Sign in / Sign up

Export Citation Format

Share Document