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Children's welfare in the health aspect can be seen in the level of growth and development of children. Socio-demographics and family food security are important because they affect the nutritional status of the community. If food security and sociodemographics are lacking, nutritional status will also be lacking and cause a decline in health status. This condition can lead to malnutrition or stunting in the community. This study aims to analyze the influence of socio-demographics and food security on the incidence of stunting in Medan City. This type of research is quantitative observational with a survey research study design using a cross-sectional study design that examines at a certain point in time the entire sample population or predetermined subset. The sample in this study was 266 toddlers from Medan Tuntungan, Medan Maimun, Medan Sunggal, Medan Helvetia and Medan Denai sub-districts. The analytical method used is bivariate analysis using the chi square test and multivariate analysis using logistic regression. The results showed that there was a positive and significant effect of the variables of mother's education, birth spacing and family income on the incidence of stunting in toddlers in Medan City with a p value <0.05. Furthermore, it was found that there was no significant effect of the variable number of children, mother's occupation and family food security on the incidence of stunting in toddlers in Medan City. Mothers should be able to find additional sources of income that can increase family income without neglecting the provision of good parenting for toddlers. This is done to increase the understanding of mothers in providing adequate nutritional intake to children under five. [ABSTRACT FROM AUTHOR]

As first births are increasingly postponed across Europe, a strong twochild family norm persists. Past research has examined educational differentials in progressions to second birth, testing various hypotheses but overlooking normative aspects. Comparing fertility surveys from France and Spain, we explore whether late first-time mothers, who have fewer reproductive biological years left to conceive, accelerate the transition to a subsequent child (time squeeze effect). We also consider a normative dimension, i.e., whether women have their first child earlier or later than others in their educational and cohort groups. In both countries, among first-time mothers between 25 and 34 years of age, highly-educated women transitioned to second birth more frequently than less-educated women did. Within the same age group, highly-educated women in Spain had a second child more quickly after the firstborn than their less educated counterparts did, while there is no such difference in France. These results hold after controlling for cohort effects, but are only partly explained by a time squeeze effect. Different normative ages at first birth by education and birth cohort explain the educational gap in the likelihood of transitioning to second birth, but not the birth intervals in Spain. In sum, our analysis demonstrates a persistent educational gap in second births in this country that cannot be reduced to biological or normative effects. This suggests that a broad range of economic constraints play a role, such as unfavourable individual economic conditions and lower levels of institutional support for parenthood. [ABSTRACT FROM AUTHOR]

BACKGROUND: Age at marriage is one of the proximate determinants of fertility. Women with early age at marriage experiences early motherhood, associated with high fertility, low education, and rural residence accompanied with poverty. In the present study, an attempt has been made to evaluate age at marriage and factors affecting it and its effect on first birth interval (FBI) using systematic review and meta-analysis. METHODOLOGY: Inclusion criteria were availability of full- and free-text articles, published in English language, and current married age of mother being 13 years and above. PubMed and Google search was used for systematic review for the study. Meta-analysis was carried out using Microsoft Excel 2013. RESULTS: Pooled-weighted average age at marriage was 19.96 years (with 4.26 standard error). The age at marriage in China was highest (21.56 years). Literacy and occupation of women had significant effect on age at marriage. Urbanization could not affect significantly on age at marriage. Furthermore, FBI has been modified by age at marriage. [ABSTRACT FROM AUTHOR]

Background Sociocultural factors remain an important determinant for women's involvement with decision making and getting husbands' support for their reproductive healthcare. Therefore this study was conducted to examine sociodemographic factors associated with women's involvement in decision making and getting husbands' support for their reproductive healthcare. Methods An institutional-based cross-sectional study was conducted in Lalitpur, Nepal. A total of 600 respondents were selected from 15 immunization clinics. Participants were women ≥18 y of age who came to the child's immunization clinic. The association between sociodemographic variables and women's involvement in decision making and getting husbands' support for their reproductive healthcare was analysed through multivariate logistic regression models. Results While women's involvement in decision making was greater for childcare, it was less in the area related to financial matters. In contrast, husbands supported more in the area related to finances than for childcare and accompanying to health facilities. The significant determinants for women's involvement in decision making and getting husbands' support were the woman's caste, education level, employment status, household income, age group and number of children. Madhesi/Muslim/other women were less likely (adjusted odds ratio [AOR] 0.31 [95% confidence interval {CI} 0.12 to 0.73]) to decide the number of babies and birth spacing. These women were also less likely (AOR 0.18 [95% CI 0.02 to 0.86]) to be accompanied by their husbands to the family planning (FP) clinic. Janajati, Dalit and Madhesi/Muslim/other women were less likely to receive their husbands' support for birth preparedness. Women who were <20 y of age and had a single child were less likely to get involved in decision making and getting their husbands' support for FP services. Conclusions The findings call for reproductive health programs that encourage women's involvement in decision making and receiving husbands' support in women's reproductive healthcare. When designing such a program in the FP area, the woman's caste, age and parity should be given special consideration. Also, caste should be considered when designing such a program related to birth preparedness. [ABSTRACT FROM AUTHOR]

Introduction: sub-optimal birth spacing is higher in sub-Saharan countries including Ethiopia. It can affect the economic, political and social aspects of a given country. Therefore, this study aimed to assess magnitude of sub-optimal child spacing practice and associated factors among childbearing women in Southern Ethiopia. Methods: a community based cross-sectional study was conducted from July to September 2020. A random sampling technique applied to select kebeles, and systematic sampling was employed to recruit study participants. Data were collected by pretested and interviewer administered questionnaire through face-to-face interviews. Data cleaned and checked for completeness, and analyzed by SPSS version 23. A p-value of < 0.05 was considered as cutoff point to declare the strength of statistical association with 95% of CI. Results: magnitude of sub-optimal child spacing practice was 61.7% (CI: 57.7: 66.2). Not attending formal education (AOR= 2.1 (95% CI: 1.3, 3.3), family planning utilization for less than 3 years (AOR= 4.0 (95% CI: 2.4,6.5), being poor (AOR= 2.0 (95% CI: 1.1, 4.0), breastfeeding of less than 24 months (AOR= 3.4 (95% CI: 1.6,6.0); having more than 6 children (AOR= 3.1 (95% CI: 1.4,6.7); and waiting time =30 minutes (AOR= 1.8 (95% CI: 1.2,5.9) were predictors of sub-optimal birth spacing practices. Conclusion: sub-optimal child spacing was relatively high among the women of Wolaita Sodo Zuria District. Improving utilization of family planning, expanding all inclusive adult education, delivering community based continuous education on optimum breast-feeding practice, involving women in income generating activities, and facilitated maternal services were recommended to fill the identified gap. [ABSTRACT FROM AUTHOR]

The route from family planning intentions to practices is not linear, it is contingent on different social factors including the preferences of individuals and couples, their gendered positions and bargaining power, the wider political, economic and social context, and also physical and bodily circumstances. We used qualitative data collected in rural Burundi between 2013 and 2016 to explore how these diverse factors influence reproductive navigation in a context framed by uncertainty and changing social norms. We describe representations of bodily (pre)dispositions for fertility and reproduction, such as the 'natural' capacity for birth spacing or the bodily capacity to use 'natural' (having a regular cycle) and 'modern' methods (not having negative side effects) that contribute collectively to an understanding of 'the body is difficult'. We found that despite these bodily constraints, women enact embodied agency to ensure livelihoods and social status, thus framing their reproductive intentions and practices. In the context of Burundi where corporeality is key to gendered social belonging, family planning programmes fail to respond to the needs and concerns of women and their embodied reproductive experiences. [ABSTRACT FROM AUTHOR]

While the family is a critical determinant of educational achievement, methodological difficulties and the availability of data limit estimation of the family contribution in school effectiveness models. This study uses multilevel modeling to estimate the proportion of variation in student educational achievement between families, family-level intraclass correlation coefficients, and specific family structure effects (family size, birth order, birth spacing, sibling sex ratio). We use cross-classified random effects to account for school and neighborhood variation. We analyze Swedish administrative education records linked with birth records for four academic cohorts of students, with siblings identified from a wider pool of 21 cohorts. We show that almost half of the variation in student achievement described as "between students" in traditional school effectiveness studies would be better described as variation "between families," suggesting effectiveness research might give greater consideration to family-based interventions in tandem with existing student- and school-based approaches to raising low achievement. [ABSTRACT FROM AUTHOR]

A hallmark of modern humans is that our newborns are neurologically immature compared to other primates. It is disputed whether this so-called secondary altriciality evolved due to remodelling of the pelvis associated with bipedal locomotion, as suggested by the obstetrical dilemma hypothesis, or from maternal energetic limitations during pregnancy. Specifically, the 'Energetics of Gestation and Growth' (EGG) hypothesis posits that birth is initiated when foetal energy requirements exceed the maximum sustained maternal metabolic rate during pregnancy at around 2.1 × basal metabolic rate (BMR) of the non-pregnant, non-lactating condition (NPNL). However, the metabolic threshold argued under the EGG framework is derived from one study with a small sample size of only 12 women from the UK. Accordingly, we performed a meta-analysis of all published studies on metabolic scopes during pregnancy to better account for variability. After excluding 3 studies with methodological issues, a total of 12 studies with 303 women from 5 high- and 3 low-income countries were analysed. On average, pregnancy was found to be less metabolically challenging than previously suggested. The studies revealed substantial variation in metabolic scope during pregnancy, which was not reflected by variation in birth timing. Further, in a third of the studies, the metabolic rates exceeded 2.1 × BMRNPNL. Our simulation of foetal energy requirements demonstrated that this metabolic threshold of 2.1 × BMRNPNL cannot realistically be crossed by the foetus around the time of birth. These findings imply that metabolic constraints are not the main limiting factor dictating gestation length. [ABSTRACT FROM AUTHOR]

Interpregnancy interval and adverse pregnancy outcomes among pregnancies following miscarriages or induced abortions in Norway (2008-2016): a cohort study. Interpregnancy interval (IPI), or the time between the end of one pregnancy and the conception of the next pregnancy, has been associated with an increased risk of adverse pregnancy outcomes. The "ins" and "outs" of interpregnancy interval effects: Who contributes, and does it matter?. [Extracted from the article]

ObjectiveShort interpregnancy interval (IPI) is associated with adverse pregnancy outcomes, including preterm birth (PTB  1.5 million California live births, we examined frequencies of short IPI between racial/ethnic groups and estimated risks by multivariable logistic regression for spontaneous PTB. We expanded the study to births 1991-2012 and utilized a "within-mother" approach to permit methodologic inquiry about residual confounding.ResultsNHB women had higher frequency (7.6%) of short IPI than non-Hispanic White (NHW) women (4.4%). Adjusted odds ratios for PTB and short IPI were 1.64 (95% CI 1.54, 1.76) for NHW and 1.49 (1.34, 1.65) for NHB. Using within-mother analysis did not produce substantially different results.ConclusionsShort IPI is associated with PTB but does not explain risk disparity between NHWs and NHBs.

BackgroundCurrent understanding of the etiology of autism is based on the interaction of multiple genes with each other and with environmental factors, leading to a neurodevelopmental process that results in the expression of autism spectrum disorder (ASD) in the child. This suggests that it might be possible to strengthen resilience to environmental stressors during the perinatal period to improve outcomes and possibly prevent the development of ASD.MethodsWe searched the MEDLINE database for multiple perinatal factors associated with the development of ASD published between January 1, 2005 and July 1, 2018. The search terms used were "autism" crossed with either "perinatal," "prenatal," "gestational," or "pregnancy," and crossed again with each perinatal risk factor highlighted in this review including topics on parental health, infections, medications, and environmental stressors. We then searched interventions that may improve neurodevelopmental outcome before and during pregnancy, including supplements, breastfeeding, and postpartum stress reduction. We identified recent or unique metanalyses and systematic reviews of the identified focus and on randomized controlled trials and summarized these using the most recent and comprehensive reviews.ResultsFolate, omega-3, vitamin D3, environmental toxin avoidance, correcting deficiencies, immune boosting, and prolonged breast feeding are all reported to be linked to the possible reduction of adverse pregnancy outcomes including ASD.ConclusionsStudies of individual components for improving pregnancy outcomes and several uncontrolled preconception to infancy medical practices suggest that multiple interventions might improve the outcomes of pregnancies where there is risk for developing ASD.

A growing body of research has argued that the traditional categories of stopping and spacing are insufficient to understand why individuals want to control fertility. In a series of articles, Timæus, Moultrie, and colleagues defined a third type of fertility motivation-postponement-that reflects a desire to avoid childbearing in the short term without clear goals for long-term fertility. Although postponement is fundamentally a description of fertility desires, existing quantitative research has primarily studied fertility behavior in an effort to find evidence for the model. In this study, we use longitudinal survey data to consider whether postponement can be identified in standard measures of fertility desires among reproductive-age women in rural Mozambique. Findings show strong evidence for a postponement mindset in this population, but postponement coexists with stopping and spacing goals. We reflect on the difference between birth spacing and postponement and consider whether and how postponement is a distinctive sub-Saharan phenomenon.

IntroductionShort interpregnancy interval (IPI) has been linked to adverse pregnancy outcomes. WHO recommends waiting at least 2 years after a live birth and 6 months after miscarriage or induced termination before conception of another pregnancy. The evidence underpinning these recommendations largely relies on data from low/middle-income countries. Furthermore, recent epidemiological investigations have suggested that these studies may overestimate the effects of IPI due to residual confounding. Future investigations of IPI effects in high-income countries drawing from large, population-based data sources are needed to inform IPI recommendations. We aim to assess the impact of IPIs on maternal and child health outcomes in high-income countries.Methods and analysisThis international longitudinal retrospective cohort study will include more than 18 million pregnancies, making it the largest study to investigate IPI in high-income countries. Population-based data from Australia, Finland, Norway and USA will be used. Birth records in each country will be used to identify consecutive pregnancies. Exact dates of birth and clinical best estimates of gestational length will be used to estimate IPI. Administrative birth and health data sources with >99% coverage in each country will be used to identify maternal sociodemographics, pregnancy complications, details of labour and delivery, birth and child health information. We will use matched and unmatched regression models to investigate the impact of IPI on maternal and infant outcomes, and conduct meta-analysis to pool results across countries.Ethics and disseminationEthics boards at participating sites approved this research (approval was not required in Finland). Findings will be published in peer-reviewed journals and presented at international conferences, and will inform recommendations for optimal IPI in high-income countries. Findings will provide important information for women and families planning future pregnancies and for clinicians providing prenatal care and giving guidance on family planning.

The association between a single interpregnancy interval (IPI) and birth outcomes has not yet been explored using matched methods. We modeled the odds of preterm birth, being small for gestational age, and having low birth weight in a second, live-born infant in a cohort of 192,041 sibling pairs born in Western Australia between 1980 and 2010. The association between IPI and birth outcomes was estimated from the interaction between birth order and IPI (with 18-23 months as the reference category), using conditional logistic regression. Matched analysis showed the odds of preterm birth were higher for siblings born following an IPI of

OBJECTIVE: To determine the effects of short inter delivery interval (IDI) on mode of delivery in patients with immediate previous one caesarean section (C-Section). METHODS: This is a retrospective chart review of 120 patients treated at Khyber Teaching Hospital, Peshawar, Pakistan from December 2017 to December 2019. Patients of previous one C-Section and with gestational age of >37 weeks were included in this study. Outcome variables were mode of delivery whether operative or vaginal delivery, maternal and fetal complications such as scar dehiscence or scar rupture and fetal distress. RESULTS: Mean age of the patients was 28.9±2 years. IDI was 24 months in 31/120 (25.8%) cases. Out of 120, 102 (85%) patients underwent trial of labour after C-section (TOLAC). TOLAC was successful in 64 (62.7%) cases. Patient who underwent TOLAC with IDI of 18 months is recommended to avoid the maternal and fetal morbidity and mortality.

Background and aim: Birth weight is an important child and maternal health indicator. Various maternal and obstetric factors are responsible for determining birth weight. If the birth weight of the newborn baby is less than 2,500 gm, the baby is considered a low birth weight (LBW) baby irrespective of the gestational age. The present study was conducted to determine the proportion of low birth weight babies among babies born at tertiary care hospitals and the association between maternal and obstetric factors and birth weight. Material and Methods: The present cross-sectional study was conducted from Sept. 2021 to Oct. 2021 among 350 mothers admitted to the postnatal ward after delivery and fulfilled the inclusion criteria. Descriptive statistics and the Chi-square test were applied for analysis. Results: In the present study, the proportion of LBW was 27.7%. In preterm (< 37 weeks) deliveries proportion of LBW was 64.4%. There was a significant association between low birth weight with gestational age, Iron and Folic Acid and calcium intake, Antenatal care visit, and birth interval. Association of low birth weight with the gender of the child, mode of delivery, maternal age, the height of the mother, maternal age at marriage, and parity was not significant. Conclusions: Antenatal care (ANC) visit, iron and folic acid (IFA) and calcium intake, gestational age, and birth interval were important factors associated with low birth weight.

Background: The possible impact of interpregnancy interval (IPI) on perinatal outcomes has long been studied, however, a definition of the optimal interval is still not clear. Both short and long IPIs have been associated with obstetrical syndromes and short and long-term complications. In this study, we sought to explore the impact of IPI on the hazard for neoplasm of the offspring, thus contribute to the present literature in determining the preferred birth spacing. Objective: We aim to investigate the association between short and long IPIs and the hazard for childhood neoplasm of the offspring. Methods: A population-based retrospective cohort analysis comparing offspring neoplasm hazard following three different IPIs. Exposure was defined as short (<6 months), or long (>60 months) IPIs, whereas intermediate IPI (6 months = 60 months) served as the comparison group. The study included singleton live births in a tertiary regional hospital between 1991 and 2014. Offspring were followed for 18 years, and all hospitalization records for neoplasm diagnoses were collected. Kaplan–Meier survival curves were used for the cumulative incidence of neoplasm morbidity, and Cox proportional hazards models were used to control for confounders. Results: During the study period, 144,397 deliveries met the inclusion criteria. Of those, 18,947 (13.1%) occurred in women with short IPI, 114,012 (79%) in women with intermediate IPI, and 11,438 (7.9%) in women with long IPI. 61 benign neoplasms and 80 malignant neoplasms were registered in offspring born after long IPI. The total percentage of neoplasm were the highest in the long IPI group versus the intermediate and short IPI groups (malignant = 0.7%, 0.6%, 0.5% respectively, benign = 0.5%, 0.4%, 0.3% respectively). Controlling for maternal age, diabetes mellitus, preterm delivery, birth weight, smoking, cesarean section, and fertility treatments, long IPI was found to be independently associated with high hazard for long-term pediatric neoplasm related hospitalizations (adjusted HR 1.39, 95% CI 1.09, 1.77). Short IPI may be associated to decreased hazard for childhood neoplasms (adjusted HR 0.74, 95% Cl 0.59, 0.92). Conclusions: Long IPI is associated with a high hazard for childhood neoplasms, compared with intermediate and short IPIs. Short IPI may be associated with decreased hazard for childhood neoplasms. [ABSTRACT FROM AUTHOR]

Background: Short birth intervals (SBIs) and long birth intervals (LBIs) have been shown to have serious implications for health of both mothers and their children. This study was aimed to investigate the determinants and reproductive outcome of SBI and LBI in a multiethnic Pakistani population.Methods: In a cross-sectional prospective study design, 2798 women admitted in a tertiary-care hospital in Islamabad for delivery were recruited and data on second or higher birth order deliveries were collected. Birth intervals were defined as short (<24 months) and long (>36 months). The reproductive outcome was defined in terms of perinatal and neonatal mortalities, and neonatal complications. Univariate and multivariate logistic regression analyses were performed.Results: Pregnancies with SBI and LBI were observed in 20% and 24% of 2798 women, respectively. Women with SBI had increased odds of perinatal death [adjusted odd ratio (AOR): 1.50] and neonatal death (AOR: 1.47) as compared to women with optimal birth intervals, while women with LBI had slightly lower odds of perinatal deaths (AOR: 0.96), but increased odds of neonatal deaths (AOR: 1.12). Further, the pregnancies with both SBI and LBI were associated with increased odds of short body length, low birth weight, small head circumference and low APGAR score.Conclusion: Nearly half of all pregnancies do not have optimal birth spacing albeit there is wide heterogeneity in the distribution of BI in various Pakistani ethnicities. Pregnancies with SBI and LBI had high risk of adverse reproductive outcome. Intervention programs for maternal and child health need to emphasize optimal birth spacing. [ABSTRACT FROM AUTHOR]

From New France, examining Jesuit dictionaries, Pearsall discerns rank and affection, and its lack, within plural marriages and divorce, including the meaning-rich word I Kiissabamigouta i : "a wife separated from her husband who does not wish to see him any more even though [they are] in the same village" (58). Pearsall describes white planters' apparent accommodation of polygamy in the households of the enslaved and of new kin arrangements that were more male-centric as necessitated by the slave trade and planter practices. Whether in New Spain, New France, or New England, Pearsall writes, "Polygamy was both a powerful European shorthand for lawlessness and a way for Indian men to make claims to power and leadership" (48). Sarah Pearsall recovers the lost history of polygamy, contextualizing the nineteenth-century controversy over Mormon polygyny and transforming our understanding of the nation's origins. [Extracted from the article]

Background and objective: Short and long intervals between successive births are associated with adverse birth outcomes, especially in low‐income and middle‐income countries, yet the birth intervals in high‐income countries remain relatively understudied. The aim was to examine maternal factors associated with birth intervals in Australia. Methods: The sample comprised 6130 participants in the Australian Longitudinal Study on Women's Health who were born in 1973‐1978, had two or more births, and responded to regular surveys between 1996 and 2018. Interbirth interval (IBI) was defined as the time between successive live births. Maternal factors were examined using accelerated failure time models. Results: For women with only two births (n = 3802), the median time to the second birth was 34.0 months (IQR 23.1, 46.2) with shorter IBI associated with higher socioeconomic status (eg, university education (31.9 months), less income stress (31.1)), and longer IBI associated with age over 35 (39.7), fair/poor health (43.0), untreated fertility problems (45.5), miscarriage (39.4), or abortion (41.0). For women with three or more births (n = 2328), the median times to the second and third births were 31.2 months (19.9, 42.1) and 36.5 months (25.3, 50.1), respectively; some factors were consistent between the first IBI and second IBI (eg, university education and being married were associated with shorter IBI), whereas income stress was associated with longer first IBI but not with second IBI. Conclusions: Understanding maternal factors associated with birth intervals in a high‐income country like Australia may enable more nuanced tailoring of guidelines for prepregnancy care. [ABSTRACT FROM AUTHOR]

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Short Birth Interval (SBI, defined as < 33 months interval between the two most recent births or < 24 months between one live birth to the next pregnancy) is a public health problem in most low- and lower-middle-income countries. Understanding geographic variations in SBI, particularly SBI hot spots and associated factors, may help intervene with tailored programs. This study identified the geographical hot spots of SBI in Bangladesh and the factors associated with them. We analyzed women's data extracted from the 2017/18 Bangladesh Demographic and Health Survey and the healthcare facility data extracted from the 2017 Service Provision Assessment. SBI was the outcome variable, and it was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization. The characteristics of mothers and their partners were the explanatory variables. Moran's I was used to examine the spatial variation of SBI in Bangladesh whereas the Getis-Ord G i ∗ (d) was used to determine the hot spots of SBI. The Geographical Weighted Regression (GWR) was used to assess the predictors of SBI at the enumeration areas' level. The variables included in the GWR were selected using the exploratory regression and ordinary least square regression model. Data of 5941 women were included in the analyses. Around 26% of the total births in Bangladesh had occurred in short intervals. A majority of the SBI hot spots were found in the Sylhet division, and almost all SBI cold spots were in the Rajshahi and Khulna divisions. No engagement with formal income-generating activities, high maternal parity, and history of experiencing the death of a child were significantly associated with SBI in the Sylhet division. Women's age of 34 years or less at the first birth was a protective factor of SBI in the Rajshahi and Khulna divisions. The prevalence of SBI in Bangladesh is highly clustered in the Sylhet division. We recommend introducing tailored reproductive health care services in the hot spots instead of the existing uniform approach across the country. [ABSTRACT FROM AUTHOR]

Introducing complementary feeding either early or later than 6 months is associated with future negative health outcomes. However, many women in Ethiopia do not follow WHO standard time to feed their children, which might be due to various demographic, economic, access, and availability of services. Thus, we aimed to identify factors attributing to the problems to assist future interventions. We used cross-sectional EMDHS 2019 for this analysis. We cleaned the data and 4061 women with under 2 years children were identified. We applied multilevel binary logistic regression in Stata v.15. Model comparison was based on log-likelihood ratio, deviance, and other criteria. We presented data using mean, percent, 95% CI, and adjusted odds ratio (AOR). The timely complementary feeding was 36.44% (34.93–37.92%). Factors like preceding birth intervals (AOR = 1.97 95% CI 1.62–1.39), primary education (AOR = 2.26 95% CI 1.40–3.62), secondary above education (AOR = 1.62 95% CI 1.10–2.38), and rich wealth index (AOR = 1.25 95% CI 1.03–1.52) were some of the associated factors. The magnitude of timely initiation of complementary feeding was diminutive. Authors suggest that interventions considering maternal education, empowering mothers economically, equity access to health services, and birth planning a good remedy. [ABSTRACT FROM AUTHOR]

Background: The level of perinatal mortality in Bangladesh is one of the highest in the world. Certain childbearing practices and low use of antenatal care make Bangladeshi women vulnerable to adverse birth outcomes. Women in Bangladesh also remain considerably subordinate to men in almost all aspects of their lives, from education and paid work to healthcare utilisation. Lack of these opportunities contributes to the low status of women within family and society, and to generally poor health outcomes for women and their children. Objective: This study investigates the risk factors of perinatal deaths in light of the low level of women's autonomy, and the relative role of childbearing practices and antenatal care in influencing the relationship between autonomy and perinatal deaths. Methods: The relevant data was extracted from the 2014 Bangladesh Demographic and Health Survey. Causal mediation analysis was undertaken to investigate the effects of mediators on the associations between women's autonomy and perinatal deaths. Results: The risk of perinatal deaths was greater by about 44% and 39% respectively for high-risk maternal age and birth interval. Those who had received sufficient antenatal care had a much lower risk of perinatal deaths compared to those who had not received sufficient care. No significant direct relationship between women's autonomy and perinatal deaths was evident. However, the influence of women's autonomy was mediated through maternal age, birth interval and antenatal care, and the average amount of mediation was approximately 9.7%, 25.6% and 9.9% respectively. Conclusions: In Bangladesh, although women's autonomy did not exert any significant direct influence on perinatal deaths, the influence was transmitted through the pathways of childbearing practices and use of antenatal care. [ABSTRACT FROM AUTHOR]

Copyright of Revue Académique des Études Sociales et Humaines is the property of Hassif Benbouali University of Chlef and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anthropometric markers are the most important aspect of a child's health assessment. Using large-scale nationally representative data from the National Family Health Survey (NFHS-4), 2015–2016, this study aimed to investigate the relationship between children born to women with high-risk fertility behaviours and children's health outcomes. The sample consisted of 2,55,726 children of currently married women aged 15–49 years in India. The key explanatory variable, high-risk fertility behaviour was defined by women's age at birth (below 18 or above 34 years), birth interval (less than 24 months), and higher birth orders (four and above). The key outcome variables for assessing child health outcomes were stunting, wasting, and underweight in children aged 0–59 months. We used descriptive statistics, Pearson's chi-square test and logistic regression models to analyse the objectives. Approximately 33% of children were born with any single high-risk condition in the last 5 years in India. The bivariate analysis showed that all three components of child health, stunting, wasting, and underweight, were higher among children born to women with high-risk fertility behaviour. The findings from the multivariable analysis suggest that children born with a high risk fertility behaviour were suffering from stunting (AOR = 1.30; 95% CI 1.27–1.33) and underweight (AOR = 1.23; 95% CI 1.20–1.27). In addition, children born to women of multiple high-risk categories had higher odds of stunting (AOR = 1.53; 95% CI 1.46–1.59) and underweight (AOR = 1.38; 95% CI 1.32–1.44) as compared to children born to women with no risk. Our findings highlight an urgent need for effective legislation to prevent child marriage that would be helpful in increasing the maternal age at birth. The government should also focus on the interventions in health education and improvement of reproductive healthcare to promote optimal birth spacing. [ABSTRACT FROM AUTHOR]

Nigeria like most developing nations still faced with a higher rate of short birth interval (SBI), and its associated consequences, such as adverse maternal and child health outcomes. This study aimed to determine the distribution and factors associated with SBI in rural and urban Nigeria. The data for this study were extracted from the 2018 Nigeria Demographic and Health Survey (2018 NDHS). Statistical analyses were descriptive analysis and binary logistic model. The proportions of SBI in rural and urban Nigeria were 20.7% and 20.3% respectively. Women's age, geopolitical region, education level, and the number of children ever born were significantly associated with SBI in rural and urban Nigeria. Maternal Wealth index and antenatal care visits were only significant in rural while working status was only significant in urban Nigeria after controlling for other factors. Higher odds of SBI for middle class women than poor women (AOR = 1.19, 95% CI = 1.06–1.35), and increase in ANC visits reduces the odds of having SBI: 4–7 visits (AOR = 0.87, 95% CI = 0.77–0.98) and > 7visits (AOR = 0.83, 95% CI = 0.69–0.99). There were slight disparities in the prevalence of short birth intervals in rural and urban areas. Wealth index and ANC visits were only significant in rural Nigeria. Public health awareness campaigns should be strengthened to drive the importance of birth spacing techniques such as the utilization of modern contraceptives and breastfeeding in all the geo-political regions and across all age strata. Women particularly those residing in the rural areas should be encouraged to advance their education to at least a secondary level and enlightened on the importance of ANC. [ABSTRACT FROM AUTHOR]

The impact of fertility decline on economic development remains central to population studies. Recent scholarship emphasizes parental investment in education as a mediator. We further develop the theoretical foundation, and empirical evidence, for the role of child health—specifically how fertility changes promote children's physical and cognitive development and thereby complement human capital accumulation through educational gains. We test this using a two-generation model applied to Indonesian longitudinal data from 1993 to 2015. Characteristics of modern fertility regimes—older maternal ages, longer interpregnancy intervals, and lower average birth orders—generally benefit offspring cognitive development and schooling. We estimate that family planning expansion, and the resulting shift in fertility traits, induced an average increase of 0.34 years of offspring educational attainment by age 18 years. Maximal maternal educational and family planning expansion would jointly produce a 1.12-year gain, including 0.20 years more directly attributable to fertility shifts. Evidence is strengthened in parallel simulations from models of within-mother shifts, in which fertility shifts resulted in a 0.16-year gain in offspring schooling. Findings contribute new evidence for the rounding effects of women's education and family planning expansion on human capital formation through child health within families and across generations. [ABSTRACT FROM AUTHOR]

Background: This exploratory study aimed to investigate factors related to infant deaths using a conceptual framework that explains the risk factors of infant deaths in developing countries.Methods: The study adopted a cross-sectional study design and used data from the 2012 and 2017 Indonesia Demographic and Health Surveys, with a sample of 3694 singleton live births in 2012 and 3413 in 2017.Results: Female infants had a lower chance of mortality compared to male infants [adjusted odds ratio (aOR) = 0.51; 95% confidence interval (CI) = 0.34-0.77]. Infants with a smaller birth size had a higher risk of infant death compared to those with an average size (aOR = 5.66; 95% CI = 3.66-8.77). The risk of infant death with a preceding birth interval of ≥24 months was lower than that with a preceding birth interval of <24 months (aOR = 0.48; 95% CI = 0.26-0.90). An older maternal age was a risk factor for infant death compared to younger mothers (aOR = 3.61; 95% CI = 1.42-9.23). Infants who were born in Sumatra (aOR = 0.38; 95% CI = 0.16-0.89) and Java and Bali (aOR = 0.33; 95% CI = 0.14-0.78) were less likely to die than infants who were born in Papua and Maluku.Conclusions: A higher infant death risk was associated with male babies and a shorter birth interval (<24 months). Mothers who perceived their babies to be small and mothers who were older (35-49 years old) were high-risk factors for infant mortality. Mothers who lived in Java and Bali as well as Sumatera were less likely to experience infant mortality compared to those who lived in Papua and Maluku. [ABSTRACT FROM AUTHOR]

Sierra Leone launched the Free Health Care Initiative, which abolished health user fees for pregnant and breastfeeding women and children under five years of age, in 2010. Combining data from the Demographic and Health Survey and a geocoded dataset for the distribution of public health facilities, I design a difference-in-differences study involving birth timing and transportation cost to investigate its impact on infant mortality and desired fertility. I find that the program does not achieve its goal of reducing infant mortality, with the lack of vaccination being a major problem. Notwithstanding the lack of reduction in infant mortality, the program leads to a significant decline in desired fertility, implying that parents may overestimate the program's benefits and change their expectations of infant mortality accordingly. Heterogeneous effects by household wealth suggest that poor households are more adversely affected by the program than wealthy ones. [ABSTRACT FROM AUTHOR]

While most mammals show birth hour peaks at times of the 24-h cycle when they are less active, there are exceptions to this general pattern. Such exceptions have been little explored, but may clarify evolutionary reasons for the diel timing of births. We investigated intraspecific variation in birth hour in wild blue monkeys Cercopithecus mitis stuhlmanni , a diurnal primate, to identify factors that differentiated daytime versus nighttime births. Behavioral and life history data from 14 groups over 14 years revealed that 4% of 484 births occurred during the day. Probability of daytime birth varied with mother's age, peaking at 15.7 years. Births whose annual timing deviated most from the population's peak birth months were 5 times more likely to occur during daytime than those that deviated less. There was no evidence that mother's rank or infant sex influenced birth hour, and mixed evidence that daytime births were more probable in larger groups. Survivorship did not differ significantly for infants born during the day versus night. Prime-aged mothers may be able to handle the consequences of an unusual birth hour more successfully than mothers with less experience or those weakened by age. Daytime birth may be more advantageous in the off-season because nights are colder at that time of year. These findings are consistent with hypotheses relating birth hour to the risk of losing social protection in group-living animals, but are not consistent with those emphasizing risk of conspecific harassment. Patterns of within-species variation can help in evaluating evolutionary hypotheses for non-random birth hour. [ABSTRACT FROM AUTHOR]

Parents are often not indifferent to the sex of their children. Indeed, while there is an overall preference for having mixed sexes in many Western countries, parents often prefer to have sons in some Asian and Caucasian countries, such as Armenia and Azerbaijan. Although migration may partly change preferences, immigrants are likely to bring with them, to some extent, the fertility preferences from their origin country. Using the confidential major files of the 2001 and the 2006 Canadian censuses, we perform Cox Proportional Hazard Models on samples ranging from a little over 1000 to a little less than 700,000 birth intervals, depending on the ethnic group, for a total of 1.1 million births. We show that some ethnic groups, such as Chinese, Indian and South Korean ethnics are more prone to shorten birth spacing after having two daughters than two sons. For example, the median birth duration between the second and third child of Indian ethnics is 39 and 53 months for two girls and two boys families, respectively. Comparing immigrants who have made their fertility decisions abroad with those having made their fertility decisions in Canada, we show that son preference changes with migration. We also demonstrate that the same ethnic groups implement their son preference in many ways, such as sex-selective abortions, differential stopping behaviours and short-birth spacing, we conclude that among Indian, Chinese and West Central Asian & Middle-Eastern ethnics, extreme short-birth spacing, of less than 6 months between birth and conception, are more common after the birth of a daughter than after the birth of a son. [ABSTRACT FROM AUTHOR]

ObjectiveTo compare associations between interpregnancy intervals (IPIs) and adverse perinatal outcomes in deliveries following IVF with deliveries following spontaneous conception or other (non-IVF) fertility treatments.DesignCohort using linked birth certificate and assisted reproductive technology surveillance data from Massachusetts and Michigan.SettingNot applicable.Patient(s)1,225,718 deliveries.Intervention(s)None.Main outcomes measure(s)We assessed associations between IPI and preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) according to live birth or nonlive pregnancy outcome in the previous pregnancy.Result(s)In IVF deliveries following previous live birth, risk of PTB was 22.2% for IPI 12 to

There remains a considerable concern among both patients and oncologists that having a live birth (LB) after breast cancer might adversely impact survival. analysis of survival in a national cohort of women with breast cancer diagnosed at age 20–39 years between 1981 and 2017 (n = 5181), and subsequent LB using Scottish Cancer Registry and national maternity records. Cases had at least one subsequent LB, each was matched with up to six unexposed cases without subsequent LB, accounting for guaranteed time bias. In 290 women with a LB after diagnosis, overall survival was increased compared to those who did not have a subsequent LB, HR 0.65 (95%CI 0.50–0.85). Women with subsequent LB who had not had a pregnancy before breast cancer showed increased survival (HR 0.56, 0.38–0.82). There was a progressively greater interaction of subsequent LB with survival with younger age, thus for women aged 20–25 years, HR 0.30 (0.12–0.74) vs. those aged 36–39, HR 0.89 (0.42–1.87). In women with LB within five years of diagnosis, survival was also increased (HR 0.66; 0.49–0.89). Survival following LB was similar to unexposed women by ER status (both positive and negative) and in those known to have been exposed to chemotherapy. This analysis provides further evidence that for the growing number of women who wish to have children after breast cancer, LB does not have a negative impact on overall survival. This finding was confirmed within subgroups, including the youngest women and those not previously pregnant. • The impact of childbirth on survival after breast cancer remains controversial. • National cancer and birth data were used to analyse an unbiased large cohort. • Live birth was associated with improved or similar survival after breast cancer. • This was confirmed by age at diagnosis, previous pregnancy, and ER status. • These findings are reassuring for young women wishing children after breast cancer. [ABSTRACT FROM AUTHOR]

Introduction. Globally, anemia among under-five children is a serious public health problem. Even if there are pocket studies here and there, there is limited evidence on the pooled prevalence of anemia among under-five children in Africa. Therefore, the aim of this study was to determine the pooled prevalence and determinants of anemia. Methods and Analysis. This systematic review and meta-analysis was done following the PRISMA guidelines. A comprehensive search was made in PubMed/MEDLINE, Cochrane Library, HINARI, and Ethiopian Journal of Health Development for studies published since 2009. It was supplemented with Google Scholar search. Study selection, data extraction, and quality of studies were assessed by eight reviewers. The Cochrane Q test and I2 test statistic were used to test the heterogeneity of studies. A random-effects model of DerSimonian-Laird method was used. Result. A total of 37 articles were included in this systematic review and meta-analysis. The pooled prevalence of anemia among under-five children in Africa was 59% (95% CI: 55, 63). Being female (AOR = 0.71; 95% CI: 0.57, 0.87), maternal education (AOR = 1.47; 95% CI: 1.31, 1.66), residence (AOR = 0.80; 95% CI: 0.67, 0.95), and family size (AOR = 0.93; 95% CI: 0.89, 0.98) were the determinants of anemia among African under-five children. Conclusion and Recommendation. This pooled study revealed that anemia was a severe public health problem. Sex, maternal education, residence, and family size were the determinants of anemia. Therefore, anemia prevention strategy should include sex consideration, educating mothers through youth education, area specific intervention, and encouraging birth spacing. [ABSTRACT FROM AUTHOR]

Sub-Saharan Africa will account for most of the growth of the world's population over the coming decades, while several other regions will begin to experience decreasing population numbers. As illustrated in Figure 2, the trends in global population size associated with the high- and low-fertility scenarios diverge considerably from the trajectory of the medium scenario and imply a range of future outcomes that is much broader than the prediction intervals of the probabilistic analysis. Long-range population projections are highly uncertain, especially for high-fertility countries still in the early stages of the demographic transition.... [T]here is a probability of 95 percent that the size of the global population will lie between 9.4 and 10.0 billion in 2050 and between 8.9 and 12.4 billion in 2100. [Extracted from the article]

Objective: Rising caesarean delivery (CD) rates throughout the world are accompanied with high rates of severe maternal complications. The aim of the present study was to analyze the outcome of trial of labor after caesarean section (TOLAC) in a Western population and identify factors associated with the success of vaginal birth after caesarean section (VBAC). Material and Methods: A retrospective study was performed at two large obstetric departments in Germany from 2008 to 2018. Women with singleton pregnancies, a history of only one previous CD with a low transverse incision, a viable fetus in cephalic presentation, and gestational age >32 weeks were included in the study. The characteristics and outcome of successful VBAC and failed TOLAC were compared. A subgroup analysis addressed gestational age, interpregnancy interval, fetal macrosomia, body mass index, and maternal age. Results: Of 1,546 patients, 62.3% achieved VBAC while 37.7% had a secondary CD. Independent factors associated with the success of TOLAC were a history of vaginal birth in previous pregnancies (p<0.001) and the use of oxytocin (p<0.001), whereas preterm birth between gestational week 32 and 37 signified a higher risk of failed TOLAC (p=0.04). The success of VBAC did not differ significantly for patients older than 40 years of age, those with a shorter interpregnancy interval than 12 months, and fetal macrosomia with birth weight exceeding 4000 grams. Maternal and neonatal outcomes were poorer in women with failed TOLAC. Conclusion: Nearly two thirds of women with a history of CD achieve VBAC in Germany. Previous vaginal birth and the augmentation of labor with oxytocin are positively associated with the achievement of VBAC and no major perinatal complications. The decision to have a TOLAC should be encouraged in the majority of patients. Further studies are needed to evaluate the feasibility of TOLAC in preterm delivery. [ABSTRACT FROM AUTHOR]

Objective: To evaluate maternal and neonatal outcomes of women with twin pregnancies following a short interpregnancy interval (IPI < 6 months).Study Design: A retrospective computerized database study in a single tertiary medical center between 2005 and 2021. Women who had an index singleton delivery and a subsequent twin gestation in their next pregnancy at the Shaare Zedek Medical Center (SZMC) were included. Maternal and neonatal outcomes of twin pregnancies following a short IPI (<6 months) were compared to those with an optimal IPI (18-48 months). Univariate analysis was followed by multiple logistic regression models; adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) were calculated.Results: During the study period, 2,079 women had an index singleton delivery followed by a twin gestation in their next pregnancy recorded at our medical center; 116 (5.9 %) had a history of short IPI, and 1,057 (50.8 %) had a history of optimal IPI. Women with a history of short IPI had higher rates of preterm labor < 37 weeks and < 34 weeks, NICU admissions and prolonged hospital stay of the first and second fetuses, mechanical ventilation of the first fetus, 1 and 5 Minute Apgar score lower than 7 of the second fetus and lower rates of elective cesarean delivery. An adjusted multivariate analysis showed that a history of short IPI was not an independent risk factor for preterm birth either < 34 weeks or < 37 weeks or for composite adverse neonatal outcome of the first and second twin.Conclusion: Twin pregnancy following a short IPI was not associated with neither preterm labor nor composite adverse neonatal outcome. [ABSTRACT FROM AUTHOR]

Background: Family planning methods prevent pregnancy-related health risks for women. Aims and Objectives: This study was undertaken to assess knowledge, attitude, and practice of various family planning methods among postnatal women in a Medical College Hospital. Materials and Methods: A standard predesigned questionnaire was asked to randomly selected 300 postnatal women who delivered at F.M. Medical College and Hospital, Balasore, Odisha, India over a period of 1 year. Data on sociodemographic variables, knowledge regarding various family planning methods, source of information, utilization, and reason for its none use were analyzed. Results: Majority were between the age group of 20-30 years (81%). About 91% were aware of its use. About 82% were aware of its need. About 75% of the women gave history of prior use of birth spacing methods. Withdrawal, oral contraceptive pills (OCP) and barrier were mostly used methods in the past (i.e., 31%, 19%, and 9%, respectively). Child spacing was most common reason for use of family planning methods. Majority were aware of OCPs (79%) followed by sterilization (72%), barrier methods (71%), intrauterine contraceptive device (53%), withdrawal (31%), and injectable (23%). Social circle (54%) and health-care provider (35%) were major source of knowledge. Man reason for non-utilization of family planning methods was desire of child (42%), fear of side effects (17%), and husband and in-law opposition (16%). Conclusion: In spite of high contraceptive knowledge and awareness, the actual use of modern family planning method is not satisfactory in our study which suggests proper counseling and education are required to increase its usage. [ABSTRACT FROM AUTHOR]

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Background: The coverage of postpartum care is not ideal, and has not been used very well due to not enough attention being paid to the puerperal women and newborns, especially in developing countries. Practice guidelines on postpartum care provide beneficial practice guidance and help to reduce maternal mortality. However, little is known about the credibility and consistency of those guidelines. This systematic review was conducted to summarize main postpartum care indications and appraise methodological quality of guidelines. Methods: Seven literature databases and guideline development institutions and organizations of obstetrics and maternity care were searched. Two reviewers independently assessed guideline quality using the AGREE II instrument, and synthesized consistent and non-consistent recommendations using the content analysis approach. Results: Twenty-nine guidelines were included and a total of eight postpartum care indications were identified. Most guidelines focused on care indications and interventions including exclusive breastfeeding, maternal nutrition, home visit, infant or newborn care and sexuality, contraception, and birth spacing. However, indications such as pain or weight management, pelvic floor muscle training, abdominal rehabilitation, and mental health got less attention. Additionally, the overall quality of all involving postpartum care guidelines is relatively good and acceptable. Conclusions: Guidelines developed by NICE, RANO, and WHO indicated higher methodological quality. For postpartum care indications, most guidelines are incomplete. Variation in practice guidelines for postpartum care recommendations exists. In the future, implementation research into shared decision-making, as well as further high-quality research to broaden the evidence base for postpartum care indications is recommended. [ABSTRACT FROM AUTHOR]

Background: Maternal and child mortality remains a major public health problem in Ethiopia. Improving short birth interval practice is a main strategy to reduce neonatal mortality, maternal mortality, adverse pregnancy outcomes, high fertility rate, and enhance economic development efforts. However, there has been limited study done regarding short birth intervals in the study area. Therefore, this study aimed to assess short birth intervals and associated factors among women who gave birth in the last three years in Dembecha district, Northwest Ethiopia, 2019. Method: A community-based cross-sectional study was conducted among 880 reproductive-age multipara mothers using a stratified cluster sampling technique. The data were collected by face-to-face interviews through pretested and semi-structured questionnaires. Bivariable and multivariable logistic regression model was fitted. Variables with a p-value ≤0.05 were considered statistically significant factors. Adjusted odds ratio with a 95% confidence interval was used to report the association between predictors and the outcome variable. Results: The prevalence of short birth interval was found to be 43.4% (95% CI: 40.2, 46.9). Husband education (able to read and write) [AOR:2.81,(95% CI:1.04,7.85)], wealth index (lowest quartile) [AOR:3.75,(95% CI:2.35,5.97), residence (urban) [AOR:3.20,(95% CI:1.62,6.33)],age at first marriage (15–17 years old) [AOR: 1.65,(95% CI:1.15, 2.26),and non-use of contraceptive [AOR: 8.78, (95% CI: 6.18, 12.47) were statistically significant variables. Conclusion: The study revealed that the prevalence of short birth intervals among multipara women is found to be high. Husband education, wealth index, urban residence, age at first marriage, and non-use of contraceptives were variables significantly associated with short birth intervals. Hence, to overcome the problem the focus should be on increasing family planning utilization, avoiding early marriage, strengthening paternal education, and improving family income. [ABSTRACT FROM AUTHOR]

Background: Globally, infant mortality is a major public health concern and a sensitive indicator of countries' socio-economic and health status. Despite the substantial reduction of under-five mortality in sub-Saharan African countries specifically in East Africa, the infant mortality rate remains highest and too far below to achieve the WHO target. As to our search of the literature is concerned, there is a dearth of evidence on the incidence and predictors of infant mortality in East Africa. Therefore, this study investigated the incidence of infant mortality and its predictors in East Africa.Methods: The present study has utilized 138,803 weighted samples from Demographic and Health Surveys (DHSs) of 12 East African countries. Considering the hierarchical nature of DHS data shared frailty parametric survival models were fitted and compared based on deviance (-2LLR), AIC, and BIC. Gompertz gamma shared frailty model was the best-fitted model for the data since it had the lowest deviance, AIC, and BIC values. Variables with a p-value < 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multivariable Gompertz gamma shared analysis, the Adjusted Hazard Ratio (AHR) with 95% Confidence Interval (CI) was reported to declare the significant predictors of infant mortality.Results: The infant mortality rate in East Africa was 41.41 per 1000 live births. Mothers aged 25-34 years, wanted birth, health facility delivery, 1-3 ANC visit, being 2nd- 4th birth order, 5th and above, the birth interval of 24-48 months, and birth interval of 49 months and above were significantly associated with lower risk of infant mortality. Whereas women who didn't have formal education, women who didn't participate in making health care decisions making, being male children, cesarean delivery, small size at birth, and large size at birth were significantly associated with a higher risk of infant mortality.Conclusion: Despite the substantial progress in improving maternal and child health, this study showed that infant mortality is still a major public health concern in East Africa. Maternal age, place of delivery, maternal education, birth size, sex of the child, mode of delivery, women's autonomy, birth order, birth interval, and ANC visit were found to be significant predictors of infant mortality. Therefore, public health interventions enhancing health facility delivery, ANC visit, maternal education, birth spacing, and empowering women are crucial for reducing the incidence of infant mortality in East Africa. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan. Methods: The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and mothers-in-law, and lady health workers (LHWs) serving in the study catchment. FGDs were audio-recorded, transcribed, and translated into English from the local language and analysed using thematic content analysis. Results: Barriers to EBF included low awareness and cultural practices of prelacteal feeds, insufficient breast milk production, undernutrition of mothers, mothers' occupation as fieldworkers, less birth spacing, low awareness about the correct technique of breastfeeding, maternal and child ailments, abnormal breasts, and influence of in-laws to start top-up feeds. Several facilitators were identified: family support, appropriate maternal diet, maternal awareness, and support in the neighborhood. Conclusion: Barriers to EBF are multifaceted in rural areas, and interventions aiming to improve adherence to EBFshould be multipronged. Awareness-raising alone might not be sufficient, and other interventions should be designed to address the barriers of maternal malnutrition, insufficient milk production, and socio-cultural practices. In addition, safe alternatives to breast milk may be necessary if breastfeeding is truly not feasible. Lack of breast milk substitutes is particularly challenging for poor rural women who cannot afford infant formula milk. [ABSTRACT FROM AUTHOR]

Background: Abortion is one of the top five causes of maternal mortality in low and middle-income countries. It is associated with a complication related to pregnancy and childbirth. Despite this, there was limited evidence on the prevalence and associated factors of abortion in East African countries. Therefore, this study aimed to investigate the prevalence and associated factors of abortion among reproductive-aged women in East African countries. Methods: The Demographic and Health Surveys (DHS) data of 12 East African countries was used. A total weighted sample of 431,518 reproductive-age women was included in the analysis. Due to the hierarchical nature of the DHS data, a multilevel binary logistic regression model was applied. Both crude and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was calculated for potential associated factors of abortion in East Africa. In the final model, variables with a p value < 0.05 were declared as statistically significant factors of abortion. Results: Around 5.96% (95%CI: 4.69, 7.22) of reproductive-aged women in East Africa had a history of abortion. Alcohol use, tobacco or cigarette smoking, being single, poorer wealth index, currently working, traditional family planning methods, and media exposure were associated with a higher risk of abortion. However, higher parity, having optimum birth intervals, and modern contraceptive uses were associated with lower odds of abortion. Conclusions: The prevalence of abortion among reproductive-aged women in East Africa was high. Abortion was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during the intervention to prevent the burdens associated with abortion. [ABSTRACT FROM AUTHOR]

Background: Globally, the estimated recurrent childbirth of one forth of women happens every two years or fewer. Next to Nigeria, Ethiopia is the second populist country in Africa and the first populist country in sub-Saharan Africa which consists of over 114 million population. There are prevalent short successive birth intervals problems in underdeveloped nations such as Ethiopia that contributes to adverse effects on mother and child health. However, studies that explore recurrent birth events and associated factors are very limited. Thus, this study aimed to explore and model the recurrent birth event by considering its subsequent within a mother and identifying its important determinants. As a result, the research findings of this study will be one of the preliminary research papers on the recurrent birth events that take into account the subsequent event and enable to be input for the policymakers, health institutions, and future researchers.Methods: A total of 4676 mothers with their 16833 corresponding children were involved in this study. The data was obtained from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). In this study, extended cox regression models such as Andersen-Gill (AG), Prentice, Williams, and Peterson total time (PWP-TT) model, PWP-gap time (PWP-GT) model, and Frailty model were employed. These all models are used to consider recurrent events within mothers and determine the potential determinants. AG, PWP-TT, and PWP-GT estimate the effect of covariates by considering the correlation between event times for a person can be explained by past events given the covariates, kth event since the entry time, kth event since the time from the previous event, respectively.Results: Among mothers who have first and ninth recurrent birth events, 75.5% and 80.1% of them respectively were rural residents while 57.6% and 70.6% of them respectively were a place of delivery in the health sector. The highest prevalence of first recurrent births (44.3%) was obtained from Muslim mothers. Mothers' education level (HR: 1.210; 95%CI: 1.010, 1.460), mothers' age at first birth (HR: 0.713; 95% CI: 0.614, 0.828), household wealth index (HR: 0.776; 95% CI: 0.625, 0.965), child mortality (HR: 0.673; 95%CI: 0.514, 0.881), household size (HR: 1.914; 95%CI:1.539,2.381) and sex of child (HR:0.836; 95%CI = 0.755,0.926) were important determinants of recurrent birth event. This indicates mothers' education level and household size were positively associated with recurrent birth events. Whereas mothers' age at first birth, household wealth index, child mortality, and sex of the child was negatively associated with recurrent birth events.Conclusion: The WHO recommends a minimum of 33 months between two consecutive births, which is longer than the Ethiopian recurrent birth intervals observed in this study. The highest recurrent birth occurred during the age of fewer than twenty years old of mothers at first birth as compared to mothers whose age was older at first birth. Mothers, children, and household characteristics had significant effects on recurrent birth events. We authors would like to recommend communities, governmental and non-governmental stakeholders consider the associated factors of frequent recurrence of birth noticed in this study. Besides, we would also like to recommend women start birth while they got mature in age to reduce frequent recurrent birth and its corresponding adverse effects. [ABSTRACT FROM AUTHOR]

Objective: To determine whether the type (intrauterine device or implant) or timing (immediately postpartum vs interval) of postpartum long-acting reversible contraception was associated with a reduction in short interpregnancy interval births.Study Design: We conducted a retrospective cohort study using linked Medicaid claims and birth certificate data from Oregon and South Carolina, 2010 to 2018. Our primary outcome was short interpregnancy interval, defined as repeat pregnancy within 18 months of the index delivery. We determined postpartum contraceptive method and timing of receipt. To assess the association of timing of long acting reversible contraception with short interpregnancy interval, we calculated adjusted probabilities from a logistic regression model incorporating covariate balanced propensity score weights, sociodemographic factors, and clustered at the woman-level.Results: Our study sample included 121,422 births to 97,084 individuals who had more than 1 birth during the study period; 41% had a short interpregnancy interval. A majority of individuals had not received any contraception by 6 months postpartum (68.6%). Overall, 15,477 individuals used long acting reversible contraception postpartum, with the majority receiving interval rather than immediate postpartum long acting reversible contraception (92.9% vs 7.1%). In multivariable analyses, both immediate postpartum (23.0%, 95% CI: 20.5%-25.8%) and interval long acting reversible contraception (15.2%, 95% CI: 14.4%-16.1%) are associated with a lower probability of short interpregnancy interval than short acting methods (42.1%, 95% CI: 41.2%-43.0%).Conclusion: Compared to short-acting methods, receipt of both immediate postpartum and interval long-acting reversible contraception is associated with lower probabilities of a subsequent short interpregnancy interval.Implications: All long acting, reversible contraception, whether placed immediately postpartum or on an interval basis, was associated with a significantly lower probability of a short interpregnancy interval than short acting or no contraceptive method. [ABSTRACT FROM AUTHOR]

[Display omitted] • Effects of birth on offspring inflammation were studied in perinatal mice. • Birth was followed by rapid changes in peripheral and central cytokines. • These patterns were similar in vaginally- and Cesarean-born mice. • An early birth advanced the pattern of inflammatory responses. • Thus, birth triggers an immune response in the offspring periphery and brain. Birth is preceded by inflammation at the fetal/maternal interface. Additionally, the newborn experiences stimuli that under any other circumstance could elicit an immune response. It is unknown, however, whether birth elicits an inflammatory response in the newborn that extends to the brain. Moreover, it is unknown whether birth mode may alter such a response. To study these questions, we first measured corticosterone and pro- and anti-inflammatory cytokines in plasma of mouse offspring at several timepoints spaced closely before and after a vaginal or Cesarean birth. We found highest levels of IL-6 one day before birth and surges in corticosterone and IL-10 just after birth, regardless of birth mode. We next examined the neuroimmune response by measuring cytokine mRNA expression and microglial number and morphology in the paraventricular nucleus of the hypothalamus and hippocampus around the time of birth. We found a marked increase in TNF-α expression in both brain regions a day after birth, and rapid increases in microglial cell number in the first three days postnatal, with subtle differences by birth mode. To test whether the association between birth and cytokine production or expansion of microglia is causal , we manipulated birth timing. Remarkably, advancing birth by a day advanced the increases in all of the markers tested. Thus, birth triggers an immune response in the body and brain of offspring. Our results may provide a mechanism for effects of birth (e.g., acute changes in cell death and neural activation) previously reported in the newborn brain. [ABSTRACT FROM AUTHOR]

This study aimed to (a) reliably obtain intermittency periods (i.e., time gaps between incarcerations) using days as the unit of time and (b) investigate the effects of mental health needs assessed during the first incarceration on the hazard of subsequent reincarcerations among justice-involved youth (JIY). The multiyear administrative data from Harris County, TX, contained 28,255 JIY who were followed up until 18 years of age. There was a progressive shortening of the time gaps between incarcerations over time. Results of conditional Cox models revealed that mental health needs had sustained, though weakened, effects on future intermittency periods. An increased reincarceration risk (shorter intermittent intervals between incarcerations) was associated with higher self-reported ratings of Alcohol/Drug Use and Angry-Irritable. A decreased reincarceration risk (longer intermittent intervals between incarcerations) was associated with higher self-reported ratings of Depression/Anxiety and Somatic Complaints. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Due to increasing heterogeneity in if, when, and under what conditions women have children, the timing, spacing, and other demographic aspects of childbearing have drastically changed in the US over the past century. Existing science tends to examine demographic aspects of childbearing separately, creating an incomplete understanding of how childbearing patterns are distributed at the population level. In this research brief, we develop the concept of childbearing biographies to emphasize that multiple childbearing characteristics cluster together. We analyze nationally representative US data from the 1979 National Longitudinal Survey of Youth (NLSY79; N = 4052). Using eight childbearing variables (e.g., age at first birth, number of children, whether unmarried at any birth), we use Mixed-Mode Latent Class Analysis (MM-LCA) and identify five classes, or childbearing biographies: (1) early compressed childbearing, (2) staggered childbearing, (3) extended high-parity childbearing, (4) later childbearing, and (5) married planned childbearing. A childbearing biography approach highlights the increasingly heterogeneous contexts of parenthood today, showing how women with similar characteristics around one aspect of childbearing (e.g., early age at first birth) can also be highly divergent from each other when taking into consideration other childbearing characteristics. In showing this complexity, we highlight that a childbearing biography approach has the potential to shed new light on widening inequality among contemporary midlife women, with implications for aging and population health and well-being. [ABSTRACT FROM AUTHOR]