Predictors of early initiation of breast feeding; Evidence from 2019 Ethiopian mini demographic and health survey

Mode Of Delivery ◽

Early Initiation ◽

Place Of Delivery ◽

Abstract Background: World health organization (WHO) recommended all mothers should be supported to initiate breastfeeding as soon as possible after birth within the first hour. This study examined the determinants of early initiation of breastfeeding in Ethiopia by using data from 2019 Ethiopia mini demographic and health survey (EMDHS)..Methods: The data for this study was extracted from 2019 EMDHS. A total of 3752 children born during the last 24 months at the time of survey were included for analysis from the nine regional states and two city administrations. Descriptive statistics was used to identify the proportion of children who had early initiation of breastfeeding (EIBF) after which multivariable logistic regression analysis was carried out to determine the predictors of EIBF. Results were presented using frequencies, percentages, p-value, crude and adjusted odds ratios. Statistical significance was declared at p <0.05 for the multivariable logistic regression analysis .Result: The prevalence of Early Initiation of Breastfeeding (EIBF) in Ethiopia was remarked to be 73.7% (n = 2767). Place of delivery [AOR =1.65, 95% CI: 1.39, 1.96] mother who deliveries at health facility had higher odds to practice early breast-feeding than those who deliveries at home, mode of delivery [ AOR = 3.94, 95% CI: 2.99, 5.17] mother who had deliveries by vaginal had 3.9 times higher odds to practice early breast-feeding compared with cesarian section and parity [ AOR = 1.57, 95% CI: 1.23, 2.00] mother who had more than five children had higher odds to practice early breastfeeding compared with first time babies. In addition, early breast-feeding initiation was also associated with region where mothers residing particularly in regions such as Oromia [AOR = 1.78, 95% CI: 1.26, 2.53] had higher odds to practice early breast feeding as compared with mothers residing in Tigray.Conclusions: The overall prevalence of EIBF was determined to be 73.7%. EIBF in Ethiopia was found to be significantly associated with place of delivery, mode of delivery, parity and region. Focus should be given to expand institutional delivery and increase awareness of mothers with their first delivery .

Early initiation of breastfeeding practice and associated factors among mothers of children aged less than six months of old in Mizan-Aman town, southwest Ethiopia, 2018

10.21203/rs.3.rs-72239/v1 ◽

2020 ◽

Author(s):

Tesfa Birlew ◽

Muluken Amare

Keyword(s):

Breast Feeding ◽

Associated Factors ◽

Early Initiation ◽

P Value ◽

Cross Sectional ◽

Timely Initiation ◽

Breastfeeding Practice ◽

Abstract BackgroundEthiopian government implemented baby-friendly hospital initiative and community integrated management of childhood illnesses program. Despite early initiation of breastfeeding taken as a key tool for tackling neonatal mortality, EIBF is still low and most of the neonatal mortalities were existed due to delayed initiation of breastfeeding in Ethiopia in general and the practice is not well documented in South West Ethiopia in particular. Therefore, this study aimed to assess early initiation of breastfeeding practice and associated factors among mothers of children aged less than six months of old in Mizan-Aman town, southwest Ethiopia.MethodsA community-based cross-sectional study was employed from April 15 to May 15, 2018. A total of 487 recently delivered mothers were included. The data was collected through face to face interview by using a pre-tested and structured questionnaire. Binary and multivariable logistic regression analysis were employed and p-value < 0.05 was identified as statistically significant factors, and the quality of the data were assured, checked, coded, cleaned and entered in Epi-Info version 3.5.3 and exported to SPSS version 25 for the analysis. ResultThe prevalence of timely initiation of breast feeding was 296(64.50%) in Mizan- Aman Town. Mothers who had < 24 months birth spacing history 1.85(AOR: 95% CI: 1.22, 2.81), mothers’ income level between 1001-1500 Ethiopian Birr 2.21 (AOR: 95% CI: 1.12, 4.37), Primipara mothers 2.00 (AOR: 95% CI: 1.24, 3.23) and home delivery 2.76(AOR: 95% CI: 1.24, 6.14) were important positive predictors for timely initiation of breast feeding. Furthermore, Government employee and merchant mother by occupation was found to be protective factors.Conclusion and recommendationThe practice of early initiation of breast feeding was suboptimal and still below the national average. Intervention at the community and facility level should paid special attention.

Early initiation of breast feeding and its associated factors among 0-23 months children in Haldwani, District Nainital

Indian Journal of Community Health ◽

10.47203/ijch.2020.v32i03.011 ◽

2020 ◽

Vol 32 (3) ◽

pp. 527-532

Author(s):

Thakkar Hemaben Kanubhai ◽

Mohd Maroof ◽

Pamei Gaihemlung ◽

Bhatt Maneesh ◽

Preeti Kumari

Keyword(s):

Breast Feeding ◽

Associated Factors ◽

Mode Of Delivery ◽

Simple Random Sampling ◽

Early Initiation ◽

P Value ◽

Delivery Mode ◽

Cross Sectional ◽

Introduction: Breastfeeding benefits both the mother and infant. It contains all the essential nutrients in an adequate amount that fulfils the infant first six month’s needs. Early initiation of breastfeeding is necessary to ensure consumption of colostrum having multiple protective factors. Aim and Objectives: To estimate the prevalence of early initiation of breast feeding and to determine its associated factors among 0- 23 months children. Methodology: A community-based cross- sectional study was carried out among 339 children aged 0-23 months in field practice areas of Rural & Urban Health Training Centres (RHTC & UHTC), Department of Community Medicine, Govt. Medical College, Haldwani, District Nainital for a period of 6 months using simple random sampling. Questions related to Early initiation of breast feeding and its associated factors were asked through Epicollect software. Wald’s statistics, Chi- square test, Fisher’s exact test were applied. P value of less than 0.05 was considered as significant. Results: The prevalence of Early Initiation of Breastfeeding was 45.1% (95% CI= 39.9%-50.5%) which was significantly associated with place of delivery, mode of delivery, mother’s education & ANC care. Conclusion: Early Initiation of Breastfeeding practice was found in almost half of children which were significantly associated with various factors highlighting the importance of addressing these factors to improve Early Initiation of Breastfeeding practices.

Determinants of Early Initiation of Breastfeeding among Mothers in a Tertiary Care Hospital

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/148 ◽

2021 ◽

Vol 8 (13) ◽

pp. 755-759

Author(s):

Subrat Kumar Pradhan ◽

Udayana Nayak ◽

Samyak Sahu ◽

Alok Ranjan Panda ◽

Jasmin Nilima Panda

Keyword(s):

Breast Feeding ◽

Rural Areas ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Mode Of Delivery ◽

Early Initiation ◽

Care Hospital ◽

Cross Sectional ◽

BACKGROUND Early initiation of breast feeding implies putting the newborn baby to the mother’s breast as soon as possible after delivery, preferably within one hour. Colostrum or ‘first milk’ which is secreted soon after birth helps build nutrient stores in the child and is rich in protective immunoglobulins for the child. Early initiation helps the child to learn suckling fast leading to early secretion of breast milk. We intended to find out the determinants of early initiation of breast feeding. METHODS This is a cross-sectional study conducted from May to August 2019 in a tertiary care hospital. The sample size was 400. The study population consisted of mothers who delivered healthy term newborns in the obstetrics and gynaecology (O & G) ward of the hospital. Interview of the mothers was done using a predesigned and pretested questionnaire. Data entry was done on Microsoft Excel and analysis was done on Epi Info 7. RESULTS Mean age of the study participants was 25.66 ± 4.228. Majority of the respondents came from rural areas (61.25 %) and were homemakers (63.5 %). More than half the respondents had either middle or secondary school education. Previous information, mode of delivery, type of family, father’s and mother’s education and mother’s occupation were significant determinants of early initiation of breastfeeding (EIBF). CONCLUSIONS The above study reveals some determinants of the practice of EIBF and efforts are needed in order to address these determinants, to improve this practice, especially in a tertiary care setup. KEYWORDS Breastfeeding, New-Born, Infant, Colostrum, Tertiary Healthcare

Association of prenatal counselling and immediate postnatal support with early initiation of breastfeeding in Uttar Pradesh, India

International Breastfeeding Journal ◽

10.1186/s13006-021-00372-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Vasanthakumar Namasivayam ◽

Bidyadhar Dehury ◽

Ravi Prakash ◽

Marissa Becker ◽

Lisa Avery ◽

...

Keyword(s):

Community Development ◽

Uttar Pradesh ◽

Early Initiation ◽

Health Facilities ◽

Cross Sectional Survey ◽

Timely Initiation ◽

Place Of Delivery ◽

Prenatal Counselling ◽

Abstract Background Timely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India. Methods Data from a cross-sectional survey of 9124 eligible women (who had a live birth in 59 days preceding the survey) conducted in 25 districts of Uttar Pradesh, India, in 2018, were used. Simple random sampling was used to randomly select 40 Community Development Blocks (sub district administrative units) in 25 districts. The Primary Sampling Units (PSUs), health service delivery unit for frontline workers, were selected randomly from a linelisting of PSUs in each selected Community Development Block. Bivariate and multivariate logistic regression analyses were performed to assess the association of prenatal counselling and postnatal support on early initiation of breastfeeding in public, private and home deliveries. Results Overall 48.1% of mothers initiated breastfeeding within an hour, with major variation by place of delivery (61.2% public, 23.6% private and 32.6% home). The adjusted odds ratio (aOR) of early initiation of breastfeeding was highest among mothers who received both counselling and support (aOR 2.67; 95% CI 2.30, 3.11), followed by those who received only support (aOR 1.99; 95% CI 1.73, 2.28), and only counselling (aOR 1.40; 95% CI 1.18, 1.67) compared to mothers who received none. The odds of early initiation of breastfeeding was highest among mothers who received both prenatal counselling and postnatal support irrespective of delivery at public health facilities (aOR 2.49; 95% CI 2.07, 3.01), private health facilities (aOR 3.50; 95% CI 2.25, 5.44), or home (aOR 2.84; 95% CI 2.02, 3.98). Conclusions A significant association of prenatal counselling and postnatal support immediately after birth on improving early initiation of breastfeeding, irrespective of place of delivery, indicates the importance of enhancing coverage of both the interventions through community and facility-based programs in Uttar Pradesh.

Higher rates of early initiation of breastfeeding associated with health facility delivery in Nepal

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1121 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Dharel ◽

A Bhattarai ◽

Y R Paudel ◽

P Acharya ◽

K Acharya

Keyword(s):

Health Facility ◽

Newborn Care ◽

Facility Delivery ◽

Early Initiation ◽

Health Facility Delivery ◽

Essential Newborn Care ◽

Place Of Delivery ◽

Nationally Representative ◽

Abstract Background Initiation of breastfeeding within one hour from birth is one of the five key essential newborn care messages, implemented along with birth preparedness package since 2008. This study aimed to determine the trend of early initiation of breastfeeding (EIBF) and to assess the effect of health facility delivery on EIBF in Nepal. Methods We analyzed the data from the last four nationally representative Nepal Demographic and Health Surveys (NDHS) conducted in 2001,2006,2011 and 2016. Data on the early initiation of breastfeeding was obtained from the mothers of infants born within 24 months prior to the survey. The explanatory variable was the place of delivery, dichotomized as either the health facility, or home delivery. Survey year had a significant interaction with the place of delivery. Multivariable logistic regression was conducted separately on pooled samples before (NDHS 2001 and 2006) and after (NDHS 2011 and 2016) the program implementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) for EIBF was calculated after adjusting for predetermined covariates. Results The rate of EIBF increased by 26.5% points (from 32.8% in 2001 to 59.3% in 2016) among infants delivered in a health facility, compared to an increase by 17.1% points (from 29.9% to 47.0%) among home born infants. EIBF increased by 32.5% points before, compared to 49.7% points after BPP. Delivery in a health facility was associated with a higher odd of EIBF in later years (AOR2.3, 95% CI 2.0,2.8), but not in earlier years (AOR1.3, 95% CI 0.9,2.0). Delivery by caesarean section, first-born infant, and lack of maternal education were associated with a lower rate of EIBF in both periods. Conclusions Higher EIBF was associated with health facility delivery in Nepal, only after programmatic emphasis on essential newborn care messages. This implies the need for explicit focus on EIBF at birth, particularly when mother is less educated, primiparous or undergoing operative delivery. Key messages The rate of initiation of breastfeeding within an hour from birth is increasing in Nepal, with higher rates in health facility delivery, as shown by the recent four nationally representative surveys. Programmatic focus on essential newborn care messages may have contributed to significant association of higher rates of early initiation of breastfeeding when delivered in health facility.

Prediction of successful de-cannulation of tracheostomised patients in medical intensive care units

Respiratory Research ◽

10.1186/s12931-021-01732-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Chul Park ◽

Ryoung-Eun Ko ◽

Jinhee Jung ◽

Soo Jin Na ◽

Kyeongman Jeon

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Goodness Of Fit ◽

Characteristic Curve ◽

Limited Data ◽

Underlying Malignancy ◽

Medical Intensive Care ◽

Good Calibration

Abstract Background Limited data are available on practical predictors of successful de-cannulation among the patients who undergo tracheostomies. We evaluated factors associated with failed de-cannulations to develop a prediction model that could be easily be used at the time of weaning from MV. Methods In a retrospective cohort of 346 tracheostomised patients managed by a standardized de-cannulation program, multivariable logistic regression analysis identified variables that were independently associated with failed de-cannulation. Based on the logistic regression analysis, the new predictive scoring system for successful de-cannulation, referred to as the DECAN score, was developed and then internally validated. Results The model included age > 67 years, body mass index < 22 kg/m2, underlying malignancy, non-respiratory causes of mechanical ventilation (MV), presence of neurologic disease, vasopressor requirement, and presence of post-tracheostomy pneumonia, presence of delirium. The DECAN score was associated with good calibration (goodness-of-fit, 0.6477) and discrimination outcomes (area under the receiver operating characteristic curve 0.890, 95% CI 0.853–0.921). The optimal cut-off point for the DECAN score for the prediction of the successful de-cannulation was ≤ 5 points, and was associated with the specificities of 84.6% (95% CI 77.7–90.0) and sensitivities of 80.2% (95% CI 73.9–85.5). Conclusions The DECAN score for tracheostomised patients who are successfully weaned from prolonged MV can be computed at the time of weaning to assess the probability of de-cannulation based on readily available variables.

Errors in the use of multivariable logistic regression analysis: An empirical analysis

Indian Journal of Community Medicine ◽

10.4103/ijcm.ijcm_16_20 ◽

2020 ◽

Vol 45 (4) ◽

pp. 559

Author(s):

RajeevKumar Malhotra

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Empirical Analysis ◽

Multivariable Logistic Regression

Impact of histologic chorioamnionitis on pulmonary hypertension and respiratory outcomes in preterm infants

Pulmonary Circulation ◽

10.1177/2045894018760166 ◽

2018 ◽

Vol 8 (2) ◽

pp. 204589401876016 ◽

Cited By ~ 2

Author(s):

Sook Kyung Yum ◽

Min-Sung Kim ◽

Yoojin Kwun ◽

Cheong-Jun Moon ◽

Young-Ah Youn ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Logistic Regression ◽

Regression Analysis ◽

Preterm Infants ◽

Multivariable Logistic Regression ◽

Histologic Chorioamnionitis ◽

Respiratory Outcomes ◽

Lower Birthweight

We aimed to evaluate the association between the presence of histologic chorioamnionitis (HC) and development of pulmonary hypertension (PH) during neonatal intensive care unit (NICU) stay. Data of preterm infants born at 32 weeks of gestation or less were reviewed. The development of PH and other respiratory outcomes were compared according to the presence of HC. Potential risk factors associated with the development of PH during NICU stay were used for multivariable logistic regression analysis. A total of 188 infants were enrolled: 72 in the HC group and 116 in the no HC group. The HC group infants were born at a significantly shorter gestational age and lower birthweight, with a greater proportion presenting preterm premature rupture of membrane (pPROM) > 18 h before delivery. More infants in the HC group developed pneumothorax ( P = 0.008), and moderate and severe bronchopulmonary dysplasia (BPD; P = 0.001 and P = 0.006, respectively). PH in the HC group was significantly more frequent compared to the no HC group (25.0% versus 8.6%, P = 0.002). Based on a multivariable logistic regression analysis, birthweight ( P = 0.009, odds ratio [OR] = 0.997, 95% confidence interval [CI] = 0.995–0.999), the presence of HC ( P = 0.047, OR = 2.799, 95% CI = 1.014–7.731), and duration of invasive mechanical ventilation (MV) > 14 days ( P = 0.015, OR = 8.036, 95% CI = 1.051–43.030) were significant factors. The presence of HC and prolonged invasive MV in infants with lower birthweight possibly synergistically act against preterm pulmonary outcomes and leads to the development of PH. Verification of this result and further investigation to establish effective strategies to prevent or ameliorate these adverse outcomes are needed.

Abstract 1847: Prognostic Impact Of Previous Percutaneous Coronary Interventions On Coronary Artery Bypass Graft Surgery: A Multicentric Analysis FromThe German Federal State North-Rhine-Westphalia

Circulation ◽

10.1161/circ.116.suppl_16.ii_395 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Parwis Massoudy ◽

Matthias Thielmann ◽

Nils Lehmann ◽

Anja Marr ◽

Georg Kleikamp ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Coronary Artery ◽

Hospital Mortality ◽

Artery Bypass ◽

Federal State ◽

Percutaneous Coronary ◽

German Federal State

Background: We have previously shown that multiple prior percutaneous coronary intervention (PCI) procedures adversely affect outcome after subsequent coronary artery bypass grafting (CABG). We were now interested to investigate this effect on a multicentric basis. Methods: Eight cardiac surgical centers from the German Federal State of North-Rhine-Westphalia provided outcome data of 37140 consecutive patients having undergone isolated first-time CABG between 01/2000 and 12/2005. Twenty-two patient characteristics and outcome variables, which are part of a collection of data claimed by the national medical quality-control commission, were retrieved from the individual databases. Three groups of patients were analyzed for overall in-hospital mortality and major adverse cardiac events (MACE): Patients without a previous PCI procedure, patients with 1 previous PCI procedure and patients with ≥2 previous PCI procedures before surgery. Unadjusted univariable and risk-adjusted multivariable logistic regression analysis were applied. Computed propensity-score matching was performed based on 15 patient major risk factors to correct for and minimize selection bias. Results: A total of 10.3% of patients had 1 previous PCI procedure, and 3.7% of patients had ≥2 previous PCI procedures. Risk-adjusted multivariable logistic regression analysis of ≥2 previous PCI significantly correlated with in-hospital mortality (odds ratio [OR], 2.0; confidence interval [CI], 1.4–3.0; P <0.0005) and MACE (OR, 1.5; CI, 1.2–1.9; P <0.0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of ≥2 previous PCI procedures was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; P =0.0016) and MACE (OR, 1.5; CI, 1.2–1.9; P =0.0019). Conclusions: This large multicentric trial supports earlier results of our single-center analysis, multiple previous PCI procedures significantly increased the event of in-hospital mortality and MACE after subsequent CABG.

Abstract TP3: Early Reocclusion After Mechanical Thrombectomy for Acute Stroke Due to Intracranial Atherosclerotic Stenosis-Related Occlusions

Stroke ◽

10.1161/str.51.suppl_1.tp3 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Masatomo Miura ◽

Yoichiro Nagao ◽

Makoto Nakajima ◽

Seigo Shindo ◽

Kuniyasu Wada ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Balloon Angioplasty ◽

Mechanical Thrombectomy ◽

Rescue Therapy ◽

Intracranial Stenting ◽

Atherosclerotic Stenosis

Background: In acute ischemic stroke (AIS) patients due to intracranial atherosclerosis-related occlusions (ICAS-O), despite successful reperfusion with mechanical thrombectomy (MT), unexpected early reocclusion sometimes occurs and worsens clinical outcome. We investigated prevalence, outcomes, and predictors of early reocclusion within 48 hours of MT in AIS due to ICAS-O. Methods: In 557 consecutive AIS patients who underwent MT from January, 2016 to March, 2019 in two stroke centers, 71 patients due to ICAS-O were retrospectively evaluated. We divided them into two groups: patients with early reocclusion and those without. Clinical and angiographical findings and outcomes were compared between the 2 groups. Multivariable logistic regression analysis was used to investigate predictors of early reocclusion after MT. Results: Of 71 patients (aged 72 ± 10 years; 23 women; median NIHSS score, 15), early reocclusion was observed in 11 (15%). The first procedure for recanalization was stent retriever in 25 patients (35%), Penumbra system in 25 patients (35%), and balloon angioplasty in 21 patients (30%). Of these, 63 patients (88%) received rescue therapy (balloon angioplasty, 50; intracranial stenting, 13). In the early reocclusion group, more number of intraprocedural reocclusion (median [IQR], 3 [2-3] vs. 1 [0-1], p < 0.001), a higher rate of remaining stenosis on the final angiography (67.6 ± 5.9% vs 57.3 ± 15.9%, p = 0.044), and a higher rate of procedure-related adverse events (27% vs 5%, p = 0.043) were observed compared to the other group. On logistic regression analysis, a total number of intraprocedural reocclusion was independently associated with early reocclusion (odds ratio, 31.4; 95% confidence interval, 2.6-375.2). Early reocclusion was related to a low rate of favorable outcome at 90 days (modified Rankin Scale ≤ 2, 9% vs 54%, p = 0.007). Conclusions: In AIS patients due to ICAS-O, early reocclusion within 48 hours was not rare and associated with unfavorable outcome. Patients with repeated intraprocedural reocclusion are at high risk for early reocclusion; they might need follow-up angiographical assessment and intensive antithrombotic treatment.