scholarly journals Risk factors for and protective factors against breastfeeding interruption before 2 years: a birth cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Graciete Oliveira Vieira ◽  
Tatiana de Oliveira Vieira ◽  
Camilla da Cruz Martins ◽  
Michelle de Santana Xavier Ramos ◽  
Elsa Regina Justo Giugliani

Abstract Background Little is known about the factors associated with the World Health Organization (WHO) recommendation of breastfeeding for at least 2 years. The objective of this study was to identify risk factors for and protective factors against breastfeeding interruption before 2 years of age. Methods In this live birth cohort, mother and infant dyads were followed for 2 years. Data collection was performed at the maternity ward and subsequently at the children’s homes, monthly during the first 6 months of life and then at 9, 12, 18, and 24 months. The outcome of interest was breastfeeding interruption before 2 years of age. Median duration of breastfeeding was estimated using Kaplan-Meier’s survival analysis, and the associations were tested using Cox’s hierarchical multivariate model. Significance was set at 5%. Results Data from a total of 1344 dyads were assessed. Median breastfeeding duration was 385 days. The following risk factors for breastfeeding interruption were identified: white skin color (adjusted hazard ratio [HRa]: 1.31; 95% confidence interval [95%CI]: 1.10–1.56), primiparity (HRa: 1.21; 95%CI: 1.05–1.40), working outside the home (HRa: 1.52; 95%CI: 1.30–1.77), child sex male (HRa: 1.18; 95%CI: 1.03–1.35) and use of a pacifier (HRa: 3.46; 95%CI: 2.98–4.01). Conversely, the following protective factors were identified: lower family income (HRa: 0.81; 95%CI: 0.71–0.94), mother-infant bed-sharing (HRa:0.61, 95%CI: 0.52–0.73), on-demand breastfeeding in the first month (HRa: 0.64; 95%CI: 0.47–0.89) and exclusive breastfeeding at 4 months (HRa: 0.58, 95%CI: 0.48–0.70). Conclusions The findings allowed to identify both risk factors for and protective factors against breastfeeding interruption before 2 years of age. Knowledge of these factors may help prevent this event and aid in the development of programs that help women maintain breastfeeding for at least 2 years, as recommended by the WHO.

2018 ◽  
Vol 19 (4) ◽  
pp. 215
Author(s):  
Sandrine Bittencourt Berger ◽  
Flávia Costa Mello ◽  
Jaqueline Costa Favaro ◽  
Flaviana Alves Dias ◽  
Ricardo Danil Guiraldo ◽  
...  

Este estudo avaliou a necessidade e uso de prótese entre 504 idosos independentes, cadastrados nas Unidades Básicas de Saúde (UBS) do município de Londrina, Paraná. As características sociodemográficas foram também analisadas. A situação quanto às próteses dentárias foi avaliada a partir de informações sobre seu uso e necessidade nos arcos superior e inferior. As observações ao exame levaram em conta os códigos e critérios preconizados pela Organização Mundial de Saúde (OMS). As informações sociodemográficas foram obtidas pela aplicação de um formulário estruturado, avaliando: sexo, idade, nível de escolaridade, estado conjugal, tipo de moradia, número de pessoas na casa, renda familiar. A idade dos 504 idosos avaliados envolveu entre 60 e 75 anos, sendo a maioria entre 65 e 74 anos (54,2%), do gênero feminino (66,3%), de procedência rural (53,8%), cor branca (62,1%) e com até 4 anos de estudo (80,6%). Destes idosos, 15,1% não usam qualquer tipo de prótese, 24,6% usam em uma arcada e 60,3% usam algum tipo de prótese nas duas arcadas. Quanto à necessidade de prótese, observou-se que 21,6% não necessitam de qualquer tipo de prótese, 19,4% necessitam em uma arcada e a maioria (58,9%) necessita nas duas arcadas. Somente houve dependência, estatisticamente significante, entre as variáveis de necessidade de prótese dentária e gênero, cor da pele e procedência. Sendo assim, pode-se concluir que a prevalência de necessidade de prótese é acentuada e existe uma demanda populacional para reabilitação protética.Palavras-chave: Epidemiologia. Idosos. Saúde Bucal.AbstractThis study evaluated the need and use of prosthesis among 504 independent elderly, registered in the Basic Health Units (BHU) of the city of Londrina, Paraná. Sociodemographic characteristics were also evaluated. The situation regarding dental prosthesis was evaluated based on information about their use and need in the upper and lower arches. The observations were performed according to the codes and criteria recommended by the World Health Organization (WHO). The sociodemographic information was obtained by applying a structured form, evaluating: gender, age, educational level, marital status, housing type, number of people living in the residence, family income. The age of the 504-elderly studied was between 65 and 74 years (54.2%), female (66.3%), rural origin (53.8%), white skin color (62.1%) and up to 4 years of schooling (80.6%). Of these elderly, 15.1% do not use any type of prosthesis, 24.6% use only in one dental arch and 60.3% use some type of prosthesis in both arches. Regarding the need of prosthesis, it was observed that 21.6% do not require any type of prosthesis, 19.4% need in one arch and the majority (58.9%) needs in both arches. There was only statistically significant dependence among the variables of need for dental prosthesis and gender, skin color and origin. Thus, it can be concluded that the prevalence of need for prosthetic is high and there is a population demand for prosthetic rehabilitation.Keywords: Epidemiology. Elderly. Oral Health.


2016 ◽  
Vol 4 (1) ◽  
pp. 26 ◽  
Author(s):  
Maged Yassin ◽  
Mohanad Taha ◽  
Samar Abu Jamiea

Wasting contributes to morbidity and mortality for children under 5 years of age particularly in the developing countries. This study identified the various risk factors associated with wasting among children aged 6 to 24 months old in Gaza Strip. The study sample consisted of 98 wasted children and 98 control children. A questionnaire interview was used. The World Health Organization Anthro software for assessing nutritional status of the world's children was applied. Data were computer analyzed using SPSS/PC statistical package version 21. Anthropometric data showed that birth weight was significantly lower in cases than controls (2.9±0.8 versus 3.1±0.6 kg, P=0.030). Weight and height were also significantly decreased in cases (P=0.000). Wasting was significantly higher among children of less educated mothers (χ2=8.110, P=0.044) and among children of less family income (OR=4.1, P=0.000). Children not received nutritional help or donation had more frequent wasting than those did (P=0.004). Wasting was significantly higher among non-exclusively breastfed children (OR=2.1, P=0.010) and among children who breastfed ≤12 months (P=0.021). Early introduction of complementary food increased wasting by 2.8 times (OR=2.8, P=0.001). Children with poor appetite had highest frequency of wasting (χ2=6.139, P=0.046). Wasting was significantly higher in respiratory and gastrointestinal tract infected children [OR=2.9, P=0.000 and OR=3.1, P=0.000, respectively). In conclusion, less income, not receive nutritional help or donation, non-exclusive breastfeeding and breastfeeding duration of ≤12 months, early start of complementary food and respiratory and gastrointestinal infections are the predicted risk factors of wasting among children in Gaza Strip.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Andréa Dâmaso Bertoldi ◽  
Tatiane da Silva Dal Pizzol ◽  
Aline Lins Camargo ◽  
Aluísio J. D. Barros ◽  
Alicia Matijasevich ◽  
...  

Background. To estimate the exposure to medicines with unknown fetal risk during pregnancy and to analyze the maternal characteristics associated with it.Methods. A questionnaire was administered to 4,189 mothers of children belonging to the 2004 Pelotas (Brazil) birth cohort study about use of any medicine during gestation. We evaluated the associations between use of medicines with unknown fetal risk and the independent variables through logistic regression models. Unknown fetal risk was defined as medicines in which studies in animals have revealed adverse effects on the fetus, and no controlled studies in women, or studies in women and animals, are available.Results. Out of the 4,189 women, 52.5% used at least one medicine from unknown fetal risk. Use of these medicines was associated with white skin color, high schooling, high income, six or more antenatal care consultations, hospital admission during pregnancy, and morbidity during gestation.Conclusion. The use of unknown fetal risk medicines is high, suggesting that their use must be addressed with caution with the aim of restricting their use to cases in which the benefits are greater than the potential risks.


2010 ◽  
Vol 26 (10) ◽  
pp. 1980-1989 ◽  
Author(s):  
Ana M. B. Menezes ◽  
Ricardo B. Noal ◽  
Juraci A. Cesar ◽  
Pedro C. Hallal ◽  
Cora Luiza Araújo ◽  
...  

The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age > 37 weeks were found to be significant risk factors.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S51-S52
Author(s):  
Kajal Mehta ◽  
Nikitha Thrikutam ◽  
Kiran K Nakarmi ◽  
Paa Ekow Hoyte-Williams ◽  
Michael Peck ◽  
...  

Abstract Introduction Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally. A cookstove is any apparatus that provides heat and is used for cooking (e.g., three-stone fire, traditional or improved cookstove). There are limited data on patterns of cooking behaviors and CSBs to inform prevention initiatives and advocacy. We aimed to describe the epidemiology, risk factors and outcomes of cooking-related burns and CSBs, specifically. Methods Patients with cooking and non-cooking related burns from 2018 to 2020 were identified in the World Health Organization (WHO) Global Burn Registry (GBR). Patient demographics, cooking arrangement, injury characteristics [mechanism, total body surface area (TBSA), revised Baux score] and outcomes were described. Differences in proportions and medians were compared. Bivariate regression was performed to identify risk factors associated with occurrence of CSB. Results GBR contained data of 6,965 burn-injured patients from 17 countries; 88% were from middle-income countries. One quarter of burn injuries (1,723 burns) were cooking-related. More than half of cooking-related burns (55%) occurred in females. Median age for cooking-related burns was 11 years (IQR 2–35). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). The most common mechanism in CSB was flame (87%), whereas the most common mechanism in other cooking burns was scald (62%). Patients with CSBs were more often female (65% vs 53%; p< 0.001) and much older than patients with other cooking burns (32 years, IQR 22–47 vs 5 years, IQR 2–30). CSBs were significantly larger in TBSA size (30%, IQR 15–45% vs 15%, IQR 10–25%; p< 0.001), had higher revised Baux scores (70, IQR 46–95 vs 28, IQR 10–25; p< 0.001) and more often resulted in death (41 vs 11%; p< 0.001) than other cooking burns (Table1). Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99–7.54) and explosions (OR 2.91, 95% CI 2.03–4.18) than other cooking injuries. Kerosene had the highest odds of CSB than all other cooking fuels (OR 2.37, 95% CI 1.52–3.69). Conclusions Cooking-related burns are common and have different epidemiology than CSBs, specifically (e.g., more often female, older, larger burn size, higher mortality). CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns.


2021 ◽  
pp. 1-14
Author(s):  
Md Mokbul Hossain ◽  
Fahmida Akter ◽  
Abu Abdullah Mohammad Hanif ◽  
Md Showkat Ali Khan ◽  
Abu Ahmed Shamim ◽  
...  

Abstract The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.


2021 ◽  
Author(s):  
Dana Barr ◽  
Nancy Fiedler ◽  
Tippawan Prapamontol ◽  
Panrapee Suttiwan ◽  
Warangkana Naksen ◽  
...  

BACKGROUND Prenatal exposure to pesticides have been linked to adverse neurodevelopmental outcomes. Gaps exist in the current literature about the timing and magnitude of exposures that result in these adverse outcomes. OBJECTIVE The Study of Asian Women and their Offspring’s Development and Environmental Exposures (SAWASDEE) Cohort was established to investigate the impact of prenatal exposure to pesticides on neurodevelopment during infancy and early childhood in northern Thailand. METHODS Recruitment of this prospective, longitudinal birth cohort began in July 2017 and was completed in June 2019 in Chom Thong and Fang, two farming districts in Chiang Mai Province in northern Thailand. Follow up of the study participants is on-going. During pregnancy, seven questionnaires were administered. Time-resolved biospecimen samples were collected monthly (for urine) and during each trimester (for blood) at antenatal care visits. Medical records were abstracted. Infants were administered the NICU Network Neurobehavioral Scale (NNNS) test at one month of age. We will complete a number of additional exposure related analyses. RESULTS A total of 1298 women were screened and of those 394 women were enrolled. The mean gestational age at enrollment was 9.9 weeks (STD = 2.6). Differences in literacy were observed between Chom Thong and Fang participants. In Fang about 51% reported being able to read in Thai compared to about 95% in Chom Thong. The percentages were comparable for reporting to be able to write in Thai. A total of 322 mother-child pairs completed the NNNS. CONCLUSIONS This longitudinal birth cohort study will inform risk assessment standards for pregnant women in Thailand and other countries. Building awareness of how insecticide exposure during specific windows of pregnancy affects the neurodevelopmental trajectories of children in developing countries is a specific need recognized by the World Health Organization.


2021 ◽  
Vol 42 (2) ◽  
pp. 394-402
Author(s):  
O.B. Aribodor ◽  
C.E. Okaka ◽  
S.O. Sam-Wobo ◽  
B.C. Okpala ◽  
D.N. Aribodor ◽  
...  

Urinary schistosomiasis is considered a major public health parasitic disease in African communities. Prior to this study, Nsugbe community was not considered endemic for the disease and as such was not involved in Praziquantel-Preventive Chemotherapy (PC). Longitudinal study of 281 consented pupils aged 5-16 years was carried out with aim of determining the status of urinary schistosomiasis. Urinalysis laboratory test strip, urine filtration technique and syndromic diagnosis were used for the confirmation of the presence of haematuria in urine samples, identification of Schistosoma haematobium ova and the confirmation of female genital schistosomiasis (FGS), respectively. Risk factors for urinary schistosomiasis infection were determined using pre-tested structured questionnaire. Data were analyzed using Minitab 17 software and intensity of infection categorized following World Health Organization (WHO) recommendations. Of the 281 pupils, 117 (42%) were males and 164 (58%) were females with mean age of 9 years. At baseline, an overall prevalence of 0.4% (1/281) which was of light intensity was established. At follow-up, an overall prevalence of 2.1% (6/281) which was of both light (16.7%) and heavy infection (83.3%) was established. The result of the clinical examination showed eggs of S. haematobium in and around the vaginal area indicating FGS of a female pupil aged 12 years. This was treated. Identified risk factors for S. haematobium infection in the community include water-contact activities, ignorance, source of water supply among others. The study revealed the need for an all inclusive mass administration of Praziquantel-PC in the study community for effective control and possible elimination.


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