Maternal exposure to O3 and NO2 may increase the risk of newborn congenital hypothyroidism: a national data-based analysis in China

Maternal exposure to air pollution during pregnancy is associated with adverse outcomes in the offspring, but limited studies focused on the impacts of gaseous air pollution on newborn congenital hypothyroidism (CH). Therefore, a national data-based analysis was conducted to explore the association between maternal exposure to gaseous air pollution and the incidence of CH in China. Annual average exposure levels of SO2, NO2, CO, and O3 from January 1, 2014, to December 30, 2014, were acquired from the Chinese Air Quality Online Monitoring and Analysis Platform. The annual incidence of newborn CH from October 1, 2014, to September 30, 2015, was collected from the Chinese Maternal and Child Health Surveillance Network. Temperature and toxic metal in wastewater in 2014 were also collected as covariates. Maternal exposure to O3 and NO2 in 1 μg/m3 level increment was positively associated with newborn CH, with an OR of 1.055 (95% CI 1.011, 1.102) and 1.097 (95% CI 1.019, 1.182) after adjusting for covariates completely. Compared with the lowest level of O3, maternal exposure to the 4th quartile of O3 was positively associated with newborn CH (OR 1.393, 95% CI 1.081, 1.794) after adjusting for covariates completely. And the 3rd and 4th quartiles of NO2 were associated positively with CH (OR 1.576, 95% CI 1.025, 2.424, and OR 1.553, 95% CI 0.999, 2.414, respectively) compared with the lowest level of NO2. By fitting the ROC curve, 93.688 μg/m3 in O3 might be used as cutoff to predict the incidence of newborn CH in China.

Nursing strategies for child health surveillance

ABSTRACT Objective: to appreciate the strategies promoted by nurses in the context of child health surveillance relevant to early childhood development. Method: this is a qualitative study with an inductive thematic analysis of the data, based on the conceptual principles of child health surveillance, and developed through semi-structured interviews with Brazilian nurses working with families in primary health care. Results: the nurses’ strategies in favor of child health surveillance focus on actions that anticipate harm with continuous follow-up and monitoring of health indicators. The process of child growth and development is the basis for responses and benefits to health, connection with the daily lives of families, active search, articulations between professionals and services, access to comprehensive care, and intrinsic actions between promotion, prevention and health follow-up. Conclusion: child health surveillance actions developed by nurses with families involve knowledge sharing, favor the resolution of problems, increase child health indicators, and strengthen the relationship between health and children’s rights, which support the promotion of development in early childhood.

The association between nutritional status and motor development in children under five years old

Background Severe malnutrition in children is closely related todelayed physical growth and mental development. Very few re-ports mention the effects of mild to moderate malnutrition on mo-tor development.Objective The objective of this study was to determine the rela-tionship between nutritional status and motor development in earlychildhood.Methods In this cross-sectional study, we examined body weightof children under 5 years of age, the ability to sit or walk withoutsupport, and parachute sign in those under 2 years of age whocame to community child health surveillance posts in TumintingSubdistrict, Manado, Indonesia.Results Among 359 under-five children, 296 were well-nourishedand 63 had mild to moderate malnutrition. The ability to sit withoutsupport in malnourished children was significantly delayed com-pared to that in well-nourished ones (P=0.03). The ability to walkwithout support and parachute sign were not significantly differentbetween the two groups.Conclusion The ability to sit without support in children with mildto moderate malnutrition is delayed compared to that in well-nour-ished ones