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Maternal Education (maternal + education)
Selected AbstractsAnxiety affects the relationship between parents and their very low birth weight infantsINFANT MENTAL HEALTH JOURNAL, Issue 3 2007Phyllis Zelkowitz The goal of this study was to examine the medical and sociodemographic factors associated with parental anxiety following the birth of a very low birth weight infant (VLBW, below 1500 g), and to determine the impact of anxiety on the behavior of parents with their VLBW infants in the Neonatal Intensive Care Unit (NICU). The parents of 88 VLBW infants were recruited through the NICU of a tertiary-care hospital, approximately 2 weeks following delivery. Parents completed self-report questionnaires measuring anxiety, marital quality, and social support. Prior to discharge, each parent was observed twice during a feeding interaction with the infant. Maternal anxiety was greater when their infants were smaller in terms of birth weight and younger in gestational age. Maternal education, marital status, and country of origin, as well as social support and marital quality, were also associated with anxiety. Paternal anxiety was not related to socioeconomic status or infant medical risk, but was associated with country of origin, social support, and marital quality. For both mothers and fathers, anxiety was a better predictor of parental behavior than was infant medical risk. These findings suggest the need to intervene with anxious parents in order to promote satisfactory parent-infant relationships. [source] Impact of the 1996 welfare reform on child and family well-beingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2009Kyunghee Lee This article examined the impact of the 1996 Welfare Reform, based on data from the National Longitudinal Survey of Youth. Using a sample of 1,681 single mothers living in poverty, this study compared the effects of economic well-being and home environment scores on their children during pre- and post-Welfare Reform years. Following the 1996 Welfare Reform, fewer mothers received cash payments, and those who did received lower payments, while more mothers worked at low-paying jobs. Negative impacts were more pronounced for less educated mothers. The effects of family income and home environment scores on children were different before and after the 1996 Welfare Reform. Maternal education moderated these associations. Instead of enforcing the current "work first" mandate, this research supports giving priority to maternal education to enhance child and family well-being in low-income families. © 2009 Wiley Periodicals, Inc. [source] Do healthy preterm children need neuropsychological follow-up?DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2010Preschool outcomes compared with term peers Aim, The aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term. Method, A total of 35 infants who were born at less than 33 weeks' gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term-born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short-term memory, visual,motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education. Results, The mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; p<0.001). Factors associated with higher Griffiths score were maternal university education (,=6.2; 95% confidence interval [CI] 0.7,11.7) and having older siblings or a twin (,=4.0; 95% CI 0.5,7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual-processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (p<0.05) and comprehension, short-term memory, and spatial abilities (p<0.01). Interpretation, Neuropsychological follow-up is also recommended for healthy very preterm children to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success. [source] Maternal fever at birth and non-verbal intelligence at age 9 years in preterm infantsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2003Olaf Dammann MD MS To test the hypothesis that characteristics of perinatal infection are associated with long-term cognitive limitations among preterm infants, we analyzed data from 294 infants (142 females, 152 males) ,1500g birthweight and <37 completed weeks of gestation who were examined at age 9 years. We identified 47 children (20 females, 27 males) who had a non-verbal Kaufman Assessment Battery for Children (K-ABC) scale standard value below 70, i.e. more than 2 SDs below the age-adjusted mean. The 247 children (122 females, 125 males) with a score ,70 served as control participants. Maternal nationality and education, and low gestational age were significantly associated with a K-ABC non-verbal standard value <70. Both neonatal brain damage (intraventricular hemorrhage) and long-term sequelae (cerebral palsy [CP], diagnosed at age 6 years) were significantly associated with a below-normal non-verbal K-ABC score. Maternal fever at birth was present in five cases (11%) and eight controls (3%; odds ratio 3.6, 95% confidence interval 1.1 to 11.4). Clinical chorioamnionitis and preterm labor and/or premature rupture of membranes (as opposed to toxemia and other initiators of preterm delivery) were also more common among cases than control participants. When adjusting for potential confounders such as gestational age, maternal education and nationality, and CP, the risk estimate for maternal fever remained unchanged (3.8, 0.97 to 14.6). We conclude that perinatal infection might indeed contribute to an increased risk for long-term cognitive deficits in preterm infants. [source] Parenting Self-Efficacy Among Mothers of School-Age Children: Conceptualization, Measurement, and Correlates,FAMILY RELATIONS, Issue 1 2000Priscilla K. Coleman Relationships among parenting self-efficacy, general self-efficacy, child and maternal characteristics, and parenting satisfaction in 145 mothers of school-aged children were examined. Higher parenting self-efficacy was observed in mothers of less emotional and more sociable children, and among mothers who were better educated, had higher family incomes, and reported more previous experience with children. Higher parenting self-efficacy and several mother and child variables predicted greater satisfaction with parenting. Influences of mothers' experience with children other than their own and maternal education on parenting satisfaction were mediated by parenting self-efficacy. Suggestions concerning the conceptualization and measurement of parenting self-efficacy are provided. [source] Interrelations between maternal smoking during pregnancy, birth weight and sociodemographic factors in the prediction of early cognitive abilitiesINFANT AND CHILD DEVELOPMENT, Issue 6 2006S. C. J. Huijbregts Abstract Maternal prenatal smoking, birth weight and sociodemographic factors were investigated in relation to cognitive abilities of 1544 children (aged 3.5 years) participating in the Québec Longitudinal Study of Children's Development. The Peabody Picture Vocabulary Test (PPVT) was used to assess verbal ability, the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) block design test to assess visuospatial ability, and the Visually Cued Recall (VCR) task to assess short-term memory. Prenatal smoking was related to performance on the WPPSI-R, the PPVT, and the VCR, although it did not independently predict any cognitive ability after maternal education was taken into account. Birth weight was a more robust predictor of all outcome measures and independently predicted VCR-performance. Birth weight interacted significantly with family income and maternal education in predicting visuospatial ability, indicating a greater influence of birth weight under relatively poor socio-economic conditions. Parenting and family functioning mediated associations between maternal education/family income and cognitive task performance under different birth weight conditions, although there were indications for stronger effects under relatively low birth weight. We conclude that investigations of moderating and mediating effects can provide insights into which children are most at risk of cognitive impairment and might benefit most from interventions. Copyright © 2006 John Wiley & Sons, Ltd. [source] Impact of the 1996 welfare reform on child and family well-beingJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2009Kyunghee Lee This article examined the impact of the 1996 Welfare Reform, based on data from the National Longitudinal Survey of Youth. Using a sample of 1,681 single mothers living in poverty, this study compared the effects of economic well-being and home environment scores on their children during pre- and post-Welfare Reform years. Following the 1996 Welfare Reform, fewer mothers received cash payments, and those who did received lower payments, while more mothers worked at low-paying jobs. Negative impacts were more pronounced for less educated mothers. The effects of family income and home environment scores on children were different before and after the 1996 Welfare Reform. Maternal education moderated these associations. Instead of enforcing the current "work first" mandate, this research supports giving priority to maternal education to enhance child and family well-being in low-income families. © 2009 Wiley Periodicals, Inc. [source] Biological, social, and community influences on third-grade reading levels of minority Head Start children: A multilevel approachJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 3 2003Virginia A. Rauh The purpose of the study was to determine the impact of individual and community level risks on school outcomes of children who attend Head Start. We studied a sample of 3,693 African American and Hispanic children who had been born in New York City, participated in Head Start, and attended New York City public schools. The outcome was the score obtained on a citywide third-grade reading test. Individual level risk factors were derived from birth certificate data. Community level risks were extracted from citywide U.S. Census data and other public-access data sets. Multilevel regression analyses indicated that at the individual level, lower reading scores were significantly associated with: male gender, low birth weight, unmarried mother, low maternal education, and inadequate interpregnancy spacing. Controlling for individual-level risk, concentrated community poverty significantly lowered reading scores, and a high percentage of immigrants in the community significantly raised scores. There was also a significant crosslevel effect: boys benefited more than girls from the immigrant community effect. The evidence suggests that we can better identify children at future educational risk and maximize the success of early intervention programs by exploring influences on school success at multiple levels, including the community. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 255,278, 2003. [source] Assessing the Effects of Age, Gestation, Socioeconomic Status, and Ethnicity on Labor InductionsJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2007Barbara L. Wilson Purpose: To evaluate the likelihood of cesarean births, related to race, ethnicity, socioeconomic status (SES), maternal education and age, and gestational status for labor inductions on primiparous and multiparous women. Design and Methods: A retrospective descriptive correlational design was used with 1,325 women scheduled for induction at a large tertiary hospital in a southwestern U.S. state from January 1 through December 31, 2005. Birth outcomes were matched against inpatient hospital scheduling induction logs to verify the reason for induction, whether elective or clinically indicated. Findings: Age and gestation had nonlinear and significant associations with cesarean birth. Elective inductions for primiparous women significantly increased the likelihood of cesarean delivery. The independent effect of being a primiparous woman with an elective induction increased the probability of a cesarean birth by 50%, but this association was not significant for multiparous women. Mother's educational level was a significant predictor for cesarean births with multiparous women being induced. Ethnicity and SES did not increase the odds of cesarean delivery following labor induction for either primiparous women or multiparous women. Conclusions: Elective inductions for primiparous women increased the probability of cesarean births. Elective labor induction for primiparous women should be offered with caution, particularly for women with advanced maternal age. [source] Predictors of neurodevelopmental outcome of Malaysian very low birthweight children at 4 years of ageJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2001LC Ong Objective: To determine neonatal, early developmental and social risk factors that predict the neurocognitive and behavioural outcome of very low birthweight (VLBW) preschool children at four years of age. Methodology: From a cohort of 151 eligible VLBW survivors born in Kuala Lumpur Maternity Hospital, 116 (76.8%) were prospectively followed up from birth till four years. A standardised neurological examination was performed at one and four years to determine the presence of impairment and cerebral palsy, respectively. Cognitive development was assessed using the Mental Scale of the Bayley Scales of Infant Development (MDI) at one year and the Weschler Preschool and Primary Scale of Intelligence-Revised (WIPPSI-R) at four years. Motor coordination was assessed using the Movement Assessment Battery for Children (Movement-ABC). Mothers completed the Child Behaviour Checklist (CBCL) and Parenting Stress Index (PSI) questionnaires. Logistic and multiple regression analyses were used to determine factors associated with cerebral palsy, IQ scores, Movement-ABC and CBCL scores. Results: Factors associated with cerebral palsy were lower MDI scores at one year (P = 0.001) and late neonatal cranial ultrasound abnormalities (P = 0.036). Minor (P = 0.016) or major impairment (P = 0.003) at one year of age and a low level of paternal education (P = 0.01) were associated with poor motor function on the Movement-ABC scale. Lower levels of maternal education (P < 0.001), impairment at one year (P = 0.002) and late neonatal cranial ultrasound abnormalities (P = 0.039) predicted Full Scale IQ scores. Higher PSI scores (P = 0.001), younger mothers (P = 0.003) and late neonatal cranial ultrasound abnormalities (P = 0.009) were associated with worsened child behaviour scores on the CBCL scale. Conclusion: Social factors and the caregiving environment were important determinants of cognitive and behavioural outcome. Cranial ultrasound abnormalities in the late neonatal period and the developmental status at one year might be useful in identifying high risk infants in need of long-term surveillance. [source] Prenatal Alcohol Exposure Alters Biobehavioral Reactivity to Pain in NewbornsALCOHOLISM, Issue 4 2010Tim F. Oberlander Objectives:, To examine biobehavioral responses to an acute pain event in a Cape Town, South Africa, cohort consisting of 28 Cape Colored (mixed ancestry) newborns (n = 14) heavily exposed to alcohol during pregnancy (exposed), and born to abstainers (n = 14) or light (,0.5 oz absolute alcohol/d) drinkers (controls). Methods:, Mothers were recruited during the third trimester of pregnancy. Newborn data were collected on postpartum day 3 in the maternity obstetrical unit where the infant had been delivered. Heavy prenatal alcohol exposure was defined as maternal consumption of at least 14 drinks/wk or at least 1 incident of binge drinking/mo. Acute stress-related biobehavioral markers [salivary cortisol, heart rate (HR), respiratory sinus arrhythmia (RSA), spectral measures of heart rate variability (HRV), and videotaped facial actions] were collected thrice during a heel lance blood collection (baseline, lance, and recovery). After a feeding and nap, newborns were administered an abbreviated Brazelton Neonatal Behavioral Assessment Scale. Results:, There were no between-group differences in maternal age, marital status, parity, gravidity, depression, anxiety, pregnancy smoking, maternal education, or infant gestational age at birth (all ps > 0.15). In both groups, HR increased with the heel lance and decreased during the postlance period. The alcohol-exposed group had lower mean HR than controls throughout, and showed no change in RSA over time. Cortisol levels showed no change over time in controls but decreased over time in exposed infants. Although facial action analyses revealed no group differences in response to the heel lance, behavioral responses assessed on the Brazelton Neonatal Scale showed less arousal in the exposed group. Conclusions:, Both cardiac autonomic and hypothalamic,pituitary,adrenal stress reactivity measures suggest a blunted response to an acute noxious event in alcohol-exposed newborns. This is supported by results on the Brazelton Neonatal Scale indicating reduced behavioral arousal in the exposed group. To our knowledge, these data provide the first biobehavioral examination of early pain reactivity in alcohol-exposed newborns and have important implications for understanding neuro-/biobehavioral effects of prenatal alcohol exposure in the newborn period. [source] Determinants of termination of breastfeeding within the first 2 years of life in India: evidence from the National Family Health Survey-2MATERNAL & CHILD NUTRITION, Issue 3 2008Rahul Malhotra Abstract The present study assesses socio-demographic and health service determinants of termination of breastfeeding within the first 2 years of life in India by analysing data from the nationally representative National Family Health Survey-2 using Cox regression modelling techniques. While the likelihood of stopping breastfeeding increased with increasing household wealth status, it declined with increasing maternal age at childbirth. The likelihood of stopping breastfeeding was significantly higher among female children compared with male children, and the gender differential was attenuated by increasing maternal educational status. Overall, findings of the present study suggest that breastfeeding promotion programmes in India should focus on certain high-risk mother,child pairs such as female infants, first-born babies, babies born in the private sector and in urban areas, as well as mothers who are literate, have a higher wealth status, are aged less than 20 years and belong to Sikh or Christian communities. Qualitative studies to understand cultural factors or norms and causal pathways responsible for the association of identified factors and early termination of breastfeeding, especially household wealth status and maternal education, are also called for. [source] Mothers' citizenship status and household food insecurity among low-income children of immigrantsNEW DIRECTIONS FOR CHILD & ADOLESCENT DEVELOPMENT, Issue 121 2008Ariel Kalil Recent data have shown that children of immigrant noncitizens experience more persistent and higher levels of food insecurity than the children of citizens following welfare reform. However, little is known about the range of factors that might explain different rates of food insecurity in the different populations. In this study, the authors used national data from the Early Childhood Longitudinal Study,Kindergarten cohort to assess this question, using multivariate probit regression analyses in a low-income sample. They found that households of children (foreign and U.S.-born) with noncitizen mothers are at substantially greater risk of food insecurity than their counterparts with citizen mothers and that demographic characteristics such as being Latina, levels of maternal education, and large household size explain about half of the difference in rates. © 2008 Wiley Periodicals, Inc. [source] Effects of early cat or dog ownership on sensitisation and asthma in a high-risk cohort without disease-related modification of exposurePAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2010Catarina Almqvist Summary Almqvist C, Garden F, Kemp AS, Li Q, Crisafulli D, Tovey ER, Xuan W, Marks GB for the CAPS investigators. Effects of early cat or dog ownership on sensitisation and asthma in a high-risk cohort without disease-related modification of exposure. Paediatric and Perinatal Epidemiology 2010; 24: 171,178. Variation in the observed association between pet ownership and allergic disease may be attributable to selection bias and confounding. The aim of this study was to suggest a method to assess disease-related modification of exposure and second to examine how cat acquisition or dog ownership in early life affects atopy and asthma at 5 years. Information on sociodemographic factors and cat and dog ownership was collected longitudinally in an initially cat-free Australian birth cohort based on children with a family history of asthma. At age 5 years, 516 children were assessed for wheezing, and 488 for sensitisation. Data showed that by age 5 years, 82 children had acquired a cat. Early manifestations of allergic disease did not foreshadow a reduced rate of subsequent acquisition of a cat. Independent risk factors for acquiring a cat were exposure to tobacco smoke at home odds ratio (OR) 1.92 [95% confidence interval (CI) 1.13, 3.26], maternal education ,12 years OR 1.95 [1.08, 3.51] and dog ownership OR 2.23 [1.23, 4.05]. Cat or dog exposure in the first 5 years was associated with a decreased risk of any allergen sensitisation, OR 0.50 [0.28, 0.88] but no association with wheeze OR 0.96 [0.57, 1.61]. This risk was not affected by age at which the cat was acquired or whether the pet was kept in- or outdoors. In conclusion, cat or dog ownership reduced the risk of subsequent atopy in this high-risk birth cohort. This cannot be explained by disease-related modification of exposure. Public health recommendations on the effect of cat and dog ownership should be based on birth cohort studies where possible selection bias has been taken into account. [source] The Asian birth outcome gapPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2006Cheng Qin Summary Asians are often considered a single group in epidemiological research. This study examines the extent of differences in maternal risks and birth outcomes for six Asian subgroups. Using linked birth/infant death certificate data from the State of California for the years 1992,97, we assessed maternal socio-economic risks and their effect on birthweight, preterm delivery (PTD), neonatal, post-neonatal and infant mortality for Filipino (87 120), Chinese (67 228), Vietnamese (45 237), Korean (23 431), Cambodian/Laotian (21 239) and Japanese (18 276) live singleton births. The analysis also included information about non-Hispanic whites and non-Hispanic blacks in order to give a sense of the magnitude of risks among Asians. Logistic regression models explored the effect of maternal risk factors and PTD on Asian subgroup differences in neonatal and post-neonatal mortality, using Japanese as the reference group. Across Asian subgroups, the differences ranged from 2.5- to 135-fold for maternal risks, and 2.2-fold for infant mortality rate. PTD was an important contributor to neonatal mortality differences. Maternal risk factors contributed to the disparities in post-neonatal mortality. Significant differences in perinatal health across Asian subgroups deserve ethnicity-specific interventions addressing PTD, teen pregnancy, maternal education, parity and access to prenatal care. [source] Secular trends in socio-economic status and the implications for preterm birthPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2006John M. D. Thompson Summary The rate of preterm birth in the developed world has been shown to be increasing, in part attributable to obstetric intervention. It has been suggested that this may be a differential increase between socio-economic groups. We aimed to assess whether the preterm rate in Norway is different in socio-economic groups defined by maternal education, and to determine the extent to which a difference is attributable to a socio-economic differential in obstetrical intervention, in terms of caesarean section or induction of labour. We used data from the Medical Birth Registry of Norway from 1980 to 1998 with preterm rate as the outcome and maternal educational level, marital status and obstetric intervention as exposure variables. In multivariable analyses, adjustment was made for maternal age, year of birth and birth order, and secular trends were assessed according to year of birth. The preterm birth rate was highest in the lowest socio-economic group. An increase of 25.2% in the preterm rate was seen over the observation period. No apparent differential was seen in the increase of the crude preterm rates between socio-economic groups, although in multivariable analyses there was a significant interaction between socio-economic group and time, implying a stronger effect of low education towards the end of the observation period attributable to demographic change. In conclusion, the preterm birth rate increased over time, but was mainly due to an increase in obstetric interventions. No closing of the gap between socio-economic groups was observed. [source] Risk factors for pre-eclampsia in nulliparous and parous women: the Jerusalem Perinatal StudyPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2005E. F. Funai Summary Pre-eclampsia has been described as a ,disease of first pregnancies' and many believe that its occurrence in a later pregnancy signals a fundamentally different entity. We sought to compare risk factors in first and subsequent pregnancies. We studied 1319 cases of pre-eclampsia recorded in a historical cohort of 82 436 deliveries in Jerusalem in 1964,76. Logistic regression was used to control for covariates. The adjusted odds ratio (OR) for pre-eclampsia in first births was 2.58 (95% confidence interval[CI] 2.23, 2.97), compared with all later birth order groups, between which there were no detectable differences in risk. Other risk factors included increasing maternal age, diabetes (OR 5.64, 95% CI 4.33, 7.35), multiple gestations (OR 3.38, 95% CI 2.54, 4.49), fetal haemolytic disease (OR 2.24, 95% CI 1.43, 3.50) and lower maternal education. The risk of pre-eclampsia was not associated with the mother's employment outside the home and did not differ between immigrants vs. Israeli-born mothers or between groups of women whose fathers had been born in Western Asia, North Africa or Europe. Effects of each risk factor were similar within first and subsequent births. These results lend no support to the hypothesis that there is a fundamental difference between pre-eclampsia in a first pregnancy compared with that occurring in a later pregnancy; conclusions may be moderated, however, by the knowledge that the incidence of pre-eclampsia was low in this historical cohort. [source] A population-based study of the recurrence of developmental disabilities , Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1991,94PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2005Kim Van Naarden Braun Summary Serious developmental disabilities (DD) are quite common and affect approximately 2% of all school-aged children. The impact of DDs with respect to the need for special education services, medical care and the demand on family members can be enormous. While this impact can be magnified for families with more than one child with a DD, little is known regarding the epidemiology of recurrence of DDs. When the cause of a DD is unknown, genetic counsellors rely on recurrence risk estimates which for DDs are over 10 years old. The objectives of our study were to: (1) assess the contribution of recurrent cases to the prevalence of DDs; (2) provide current, population-based recurrence risk estimates; and (3) examine characteristics of the first affected child as predictors of recurrence. Two population-based data sources were used to identify all children born to the same mother during the period 1981,91 in the five-county metropolitan Atlanta area with at least one of four DDs: mental retardation (MR), cerebral palsy, hearing loss, or vision impairment. Recurrence risk estimates for these DDs ranged from 3% to 7% and were many times higher than the background prevalences. The risk of recurrence of DDs was greatest for MR , approximately eight times greater than the baseline MR prevalence. Isolated mild MR (IQ 50,70) was highly concordant between siblings with MR. Sex, race, and birthweight of the index child, maternal education, and maternal age were not significantly associated with recurrence risk. Further research is needed to investigate the roles of genetic and environmental factors on the recurrence of DDs, particularly isolated mild MR. [source] Extreme prematurity and school outcomesPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2000G.M. Buck The purpose of this study was to assess the impact of extreme prematurity on three global measures of school outcomes. Using a matched cohort design, exposed infants comprised all surviving singleton infants 28 weeks gestation born at one regional neonatal intensive care hospital between 1983 and 1986 (n = 132). Unexposed infants comprised randomly selected full-term infants ( 37 weeks gestation) frequency matched on date of birth, zip code and health insurance. All children were selected from a regional tertiary children's centre serving western New York population. Standardised telephone interviews elicited information on grade repetition, special education placement and use of school-based services. Unconditional logistic regression was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) adjusted for potential confounders for children without major handicaps. Extreme prematurity was associated with a significant increase in risk of grade repetition (OR = 3.22; 95% CI = 1.63, 6.34), special education placement (OR = 3.16; 95% CI = 1.14, 8.76) and use of school-based services (OR = 4.56; 95% CI = 1.82, 11.42) in comparison with children born at term, even after controlling for age, race, maternal education, foster care placement and the matching factors. These findings suggest that survivors of extreme prematurity remain at risk of educational underachievement. [source] Maternal pre-eclampsia/eclampsia and the risk of sudden infant death syndrome in offspringPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2000De-Kun Li To determine whether maternal exposure to pre-eclampsia/eclampsia during pregnancy increases the risk of sudden infant death syndrome (SIDS) in offspring, we conducted a population-based case,control study using the California linked birth and death certificate data. All infants who died of SIDS (ICD-9 code 798.0) during 1989,91 were identified as cases. More than 96% of the identified SIDS cases were diagnosed through autopsy. Ten controls who did not die from SIDS were randomly selected for each case from the birth certificate matched to the case on the year of birth. Among 2029 cases and 21 037 controls included in the final analysis, mothers of 49 cases (2.4%) and 406 controls (1.9%) had a diagnosis of either pre-eclampsia or eclampsia noted on the birth certificate. After adjustment for maternal age, prenatal smoking, race/ethnicity, parity, maternal education, gestational age at the initial visit for prenatal care, infant year of birth and infant sex, maternal pre-eclampsia/eclampsia during pregnancy was associated with a 50% increased risk of SIDS in the offspring (odds ratio = 1.5, 95% confidence interval 1.1, 2.0). Potential under-reporting of pre-eclampsia/eclampsia on the birth certificates was likely to be non-differential and is unlikely to explain the finding. Fetal hypoxia resulting from pre-eclampsia/eclampsia or immunological aetiology affecting the risk of both pre-eclampsia/eclampsia and SIDS may explain the finding. [source] Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze.PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 4p2 2010Prospective birth cohort study in 4-year olds Jedrychowski WA, Perera FP, Maugeri U, Mrozek-Budzyn D, Mroz E, Klimaszewska-Rembiasz M, Flak E, Edwards S, Spengler J, Jacek R, Sowa A. Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze. Prospective birth cohort study in 4-year olds. Pediatr Allergy Immunol 2010: 21: e723,e732. © 2010 John Wiley & Sons A/S The main goal of the study was to determine the relationship between prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) measured by PAH-DNA adducts in umbilical cord blood and early wheeze. The level of PAH-DNA adducts in the cord blood is assumed to reflect the cumulative dose of PAHs absorbed by the foetus over the prenatal period. The effect of prenatal PAH exposure on respiratory health measured by the incidence rate ratio (IRR) for the number of wheezing days in the subsequent 4 yr follow-up was adjusted for potential confounding factors such as personal prenatal exposure to fine particulate matter (PM2.5), environmental tobacco smoke (ETS), gender of child, maternal characteristics (age, education and atopy), parity and mould/dampness in the home. The study sample includes 339 newborns of non-smoking mothers 18,35 yr of age and free from chronic diseases, who were recruited from ambulatory prenatal clinics in the first or second trimester of pregnancy. The number of wheezing days during the first 2 yr of life was positively associated with prenatal level of PAH-DNA adducts (IRR = 1.69, 95%CI = 1.52,1.88), prenatal particulate matter (PM2.5) level dichotomized by the median (IRR = 1.38; 95%CI: 1.25,1.51), maternal atopy (IRR = 1.43; 95%CI: 1.29,1.58), mouldy/damp house (IRR = 1.43; 95%CI: 1.27,1.61). The level of maternal education and maternal age at delivery was inversely associated with the IRRs for wheeze. The significant association between frequency of wheeze and the level of prenatal environmental hazards (PAHs and PM2.5) was not observed at ages 3 or 4 yrs. Although the frequency of wheezing at ages 3 or 4 was no longer associated with prenatal exposure to PAHs and PM2.5, its occurrence depended on the presence of wheezing in the first 2 yr of life, which nearly tripled the risk of wheezing in later life. In conclusion, the findings may suggest that driving force for early wheezing (<24 months of age) is different to those leading to later onset of wheeze. As we reported no synergistic effects between prenatal PAH (measured by PAH-DNA adducts) and PM2.5 exposures on early wheeze, this suggests the two exposures may exert independent effects via different biological mechanism on wheeze. [source] Racial and ethnic disparities in low birth weight delivery associated with maternal occupational characteristicsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010John D. Meyer MD Abstract Objectives Work characteristics and maternal education have both been associated with low birth weight (LBW) delivery. We sought to examine the relative contribution of these two factors to LBW delivery and determine whether ethnic/racial differentials in educational attainment and work characteristics might play a role in well-described disparities in LBW. Methods Scores for work substantive complexity (SC) derived from the O*NET were imputed to maternal occupation for Connecticut singleton births in 2000. Risks for LBW were estimated separately for black, Hispanic, and white mothers using logistic regression controlling for maternal covariates. Results Using white mothers as a referent, working is associated with reduced LBW risk in black mothers compared to those not in work (OR 2.06 vs. 3.07). LBW in working black women was strongly associated with less that a high school education (OR 4.80, 95% CI 1.68,13.7), and with low work SC in blacks in those with a college education or greater (OR 4.48, 95% CI 1.24,16.2). Examination of work SC scores, controlling for age and educational level, showed lower values for blacks; increased work SC was seen in Hispanics after adjustment for lower educational attainment. A decrease in risk for LBW was seen in black mothers, compared with whites, as work SC increased. By contrast, college-educated black mothers had a greater risk for LBW than those with high school or some college education. Conclusions Maternal employment and work in a job with greater SC were associated with a reduced risk of LBW in black mothers. Improved LBW risk was also seen with employment in Hispanics. Low work SC in those with higher educational attainment was strongly associated with LBW in blacks, but not whites or Hispanics. Education/work mismatch may play a role in racial disparities in birth outcomes. Am. J. Ind. Med. 53:153,162 2010. © 2009 Wiley-Liss, Inc. [source] Job control, substantive complexity, and risk for low birth weight and preterm delivery: An analysis from a state birth registryAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2007John D. Meyer MD Abstract Background Indices of job strain have demonstrated a variable relationship to low birth weight (LBW) and prematurity, with conflicting study results. This study sought to examine the associations of psychosocial work environment characteristics with adverse pregnancy outcomes using and comparing the demand-control model and job attributes derived from the O*NET. Methods Job characteristics were imputed to maternal occupation recorded in the 2000 Connecticut state birth registry for 26,408 singleton births, using scores for psychological job demands, control, and physical demands derived from the Job Content Questionnaire, and for substantive complexity of work and physical demands using variables derived from O*NET job attributes. Odds ratios for LBW and preterm delivery were estimated while controlling for relevant covariates. Results High psychological demands were not associated with pregnancy outcomes, while high physical demand scores from the O*NET were associated with LBW. Associations of term- and all-LBW with both low control and low substantive complexity were attenuated by adjustment for educational and demographic covariates. A gradient with lower scores was seen for term LBW and substantive complexity, and for prematurity and control. Both constructs were correlated with maternal education. Conclusions These results suggest that low maternal job control and substantive complexity may be modestly associated with LBW and, to a lesser extent, prematurity. A greater association with control may explain why a weak link of birth outcomes to high-strain work has been noted in past studies. Observed associations with occupational are reduced after adjustment for relevant confounding variables, in particular educational level and race/ethnicity. Am. J. Ind. Med. 50:664,675, 2007. © 2007 Wiley-Liss, Inc. [source] Production, Reproduction, and Education: Women, Children, and Work in a British PerspectivePOPULATION AND DEVELOPMENT REVIEW, Issue 3 2002Heather Joshi This article reviews findings of studies by the author and colleagues on relationships between women's work and the reproduction of the British population based on data for female birth cohorts 1922,70. The studies address three questions: (1) How do children affect women's paid work and lifetime earnings? (2) How does women's employment affect the quantity of children born? (3) How does women's employment affect the "quality" of children? The answers are affected by the woman's educational attainment. On question 1, childrearing may often halve lifetime earnings, but seldom for the well educated. By contrast, any effects from employment to childbearing are most apparent in the late motherhood of the well educated. Child quality, as assessed by indicators of child development, benefits from maternal education and suffers little from maternal employment. The economic advantages for children in dual-career families are thus unabated. A widening gulf between mothers will tend to polarize the life chances of their children, unless there are more options to combine employment and childrearing, especially including good-quality child care for those who cannot afford the market price. Education is a powerful influence, but does not alone solve all issues of equity, whether between families or between sexes. [source] The influence of maternal and child characteristics and paternal support on interactions of mothers and their medically fragile infants,RESEARCH IN NURSING & HEALTH, Issue 1 2007Tzu-Ying Lee Abstract The influences of maternal characteristics, infant characteristics, and paternal support on maternal positive involvement and developmental stimulation were examined over time in 59 mothers and their medically fragile infants using an ecological framework. Higher maternal education was associated with greater maternal positive involvement. More maternal depressive symptoms, more infant technological dependence, and lower birthweights were associated with less maternal positive involvement at 6 months but greater involvement at 12 months. Higher paternal helpfulness facilitated positive involvement in mothers with low depressive symptoms but not in those with elevated symptoms. Higher maternal education and more depressive symptoms were associated with more developmental stimulation. Thus, maternal interactive behaviors are affected by maternal, infant, and environment factors, and these effects change over time. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 17,30, 2007 [source] Identifying predictors of breastfeeding self-efficacy in the immediate postpartum period,RESEARCH IN NURSING & HEALTH, Issue 4 2006Cindy-Lee E. Dennis Abstract Researchers have found evidence that breastfeeding self-efficacy is an important variable that significantly influences initiation and duration rates. The purpose of this study was to develop a multi-factorial predictive model of breastfeeding self-efficacy in the first week postpartum. As part of a longitudinal study, a population-based sample of 522 breastfeeding mothers in a health region near Vancouver, British Columbia completed mailed questionnaires at 1-week postpartum. Bivariate correlations were used to select variables for the multiple regression analysis. The best-fit regression model revealed eight variables that explained 54% of the variance in Breastfeeding Self Efficacy Scale (BSES) scores at 1-week postpartum: maternal education, support from other women with children, type of delivery, satisfaction with labor pain relief, satisfaction with postpartum care, perceptions of breastfeeding progress, infant feeding method as planned, and maternal anxiety. The BSES may be used to identify risk factors, enabling health professionals to improve quality of care for new breastfeeding mothers. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29: 256,268, 2006 [source] Culture and psychiatric symptoms in Puerto Rican children: longitudinal results from one ethnic group in two contextsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 5 2008Cristiane S. Duarte Background:, The development of youth psychopathology may be associated with direct and continuous contact with a different culture (acculturation) and to distress related to this process (cultural stress). We examine cultural experiences of Puerto Rican families in relation to youth psychiatric symptoms in two different contexts: one in which migrant Puerto Ricans reside on the mainland as an ethnic minority and another in which they reside in their place of origin. Methods:,Sample: Probability samples of 10- to 13-year-old youth of Puerto Rican background living in the South Bronx, New York City (SB) and in the San Juan Metropolitan area in Puerto Rico (PR) (N = 1,271) were followed over time. Measures: Three assessments of internalizing psychiatric symptoms (elicited through the DISC-IV) and of antisocial behaviors (ASB) quantified through a six-point index were carried out. Independent variables included scales of adult and child acculturation and cultural stress, and other putative correlates. Data analysis: Within each study site, multilevel linear regression models were examined. Results:, Parental acculturation was associated with ASB in youth at both sites, but youth acculturation itself was not related to psychiatric symptoms. At both contexts, cultural stress was a more consistent correlate of youth psychiatric symptoms than acculturation after controlling for nativity, maternal education, child gender, stressful life events and parental psychopathology. However, the strength of the youth cultural stress association decreased over time. Conclusion:, The association between cultural factors and child psychiatric symptoms is not restricted to contexts where an ethnic group is a minority. [source] Pacific Islands Families Study: behavioral problems among two-year-old Pacific children living in New ZealandTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 5 2007Janis Paterson Background:, The aim of this study was to determine (1) the prevalence of behavioral problems among two-year-old Pacific children living in New Zealand, (2) ethnic differences in behavioral problems, and (3) relationships between maternal and socio-demographic variables and problem child behavior. Methods:, Data were gathered from the Pacific Islands Families (PIF) Study. Mothers of a cohort of 1398 Pacific infants born in Auckland, New Zealand during 2000 were interviewed when the children were two years of age. Maternal reports (1028) of child behavior were obtained using the Child Behavior Checklist (CBCL). Results:, In the PIF cohort, 15.6% of children were in the clinical range with one or more deviant scores from the seven syndrome scales, and 14% were in the borderline range. The prevalence rate of internalizing problems was 17.1% in the clinical range and 8.9% in the borderline range. The prevalence rate of externalizing problems was 6.6% in the clinical range and 13.7% in the borderline range. The prevalence rate of total problems was 14.2% in the clinical range and 9.6% in the borderline range. Discipline and maternal education were significantly associated with elevated externalizing scores. Household size, maternal education, cultural orientation, and number of years living in New Zealand were significantly associated with internalizing scores. Child ethnicity was significantly associated with internalizing, externalizing and total problem behavior scores. In the clinical range, child ethnicity and gender were significantly associated with the prevalence of problem behavior. Conclusions:, Cross-ethnicity differences in CBCL scores were found, which illustrates the diversity in the Pacific population in New Zealand. Such findings highlight the way in which preschool behavior problems may vary within specific cultural settings and underscore the need for in-depth research to explore these unique contexts. [source] A behavioural genomic analysis of DNA markers associated with general cognitive ability in 7-year-oldsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 10 2005Nicole Harlaar Background:, Five DNA markers (single-nucleotide polymorphisms, SNPs) have recently been found to be associated with general cognitive ability (,g') in a sample of 7414 7-year-old twins. These children have also been studied at 2, 3, 4, and 7 years of age on measures of cognitive and language development and behaviour problems; family environment was also assessed. Methods:, We used these data to conduct a behavioural genomic analysis of the five SNPs and a composite of them (,SNP set') that explored developmental, multivariate, and genotype,environment (GE) issues. Results:, The ,g' SNP set identified at 7 years yielded significant associations with ,g' as early as 2 years. In multivariate analyses at 7 years, the ,g' SNP set was more strongly associated with verbal than nonverbal ability and with reading more than mathematics performance. GE correlations were found between the SNP set for ,g' at 7 years and preschool proximal measures of the family environment (chaos and discipline) rather than distal measures (maternal education and father's occupational class), suggesting evocative rather than passive GE correlation. Significant GE interactions were found for discipline, education and occupation in which the association between the SNP set and ,g' at 7 years is stronger in low-risk environments. Conclusions:, Although the effect sizes of the five SNP associations are very small, behavioural genomic analyses using a ,g' SNP set illustrate how developmental, multivariate and GE questions can be addressed as more DNA associations are identified for complex traits such as ,g'. [source] Factors Related to Genital Tract Trauma in Normal Spontaneous Vaginal BirthsBIRTH, Issue 2 2006Leah L. Albers CNM In settings with very low rates, evidence remains sparse on how best to facilitate birth without lacerations. The purpose of this investigation was to identify maternal and clinical factors related to genital tract trauma in normal, spontaneous vaginal births. Methods:Data from a randomized clinical trial of perineal management techniques were used to address the study objective. Healthy women had spontaneous births with certified nurse-midwives in a medical center setting. Proportions of maternal characteristics and intrapartum variables were compared in women who did and did not sustain sufficient trauma to warrant suturing, according to parity (first vaginal births versus others). Logistic regression using a backward elimination strategy was used to identify predictors of obstetric trauma. Results: In women who had a first vaginal birth, risk factors for trauma were maternal education of high school or beyond, Valsalva pushing, and infant birthweight. Risk factors in women having a second or higher vaginal birth were prior sutured trauma and infant birthweight. For all mothers, delivery of the infant's head between contractions was associated with reduced trauma to the genital tract. Conclusions:Delivery technique that is unrushed and controlled may help reduce obstetric trauma in normal, spontaneous vaginal births. (BIRTH 33:2 June 2006) [source] | ||||||||||||||||||||||||||||