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Di J, Bai J, Zhang J, Chen J, Hao Y, Bai J, Xiang C. Regional disparities, age-related changes and sex-related differences in knee osteoarthritis. BMC Musculoskelet Disord 2024; 25:66. [PMID: 38225636 PMCID: PMC10788997 DOI: 10.1186/s12891-024-07191-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/10/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The objective of the study is to analyse the regions, age and sex differences in the incidence of knee osteoarthritis (KOA). METHODS Data were extracted from the global burden of diseases (GBD) 2019 study, including incidence, years lived with disability (YLD), disability-adjusted life-years (DALYs) and risk factors. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in age standardized rate (ASR) of KOA. Paired t-test, paired Wilcoxon signed-rank test and spearman correlation were performed to analyze the association of sex disparity in KOA and socio-demographic index (SDI). RESULTS There were significant regional differences in the incidence of knee osteoarthritis. In 2019, South Korea had the highest incidence of knee osteoarthritis (474.85,95%UI:413.34-539.64) and Thailand had the highest increase in incidence of knee osteoarthritis (EAPC = 0.56, 95%CI = 0.54-0.58). Notably, higher incidence, YLD and DALYs of knee osteoarthritis were associated with areas with a high socio-demographic index (r = 0.336, p < 0.001; r = 0.324, p < 0.001; r = 0.324, p < 0.001). In terms of age differences, the greatest increase in the incidence of knee osteoarthritis was between the 35-39 and 40-44 age groups. (EAPC = 0.52, 95%CI = 0.40-0.63; 0.47, 95%CI = 0.36-0.58). In addition, there were significant sex differences in the disease burden of knee osteoarthritis (P < 0.001). CONCLUSIONS The incidence of knee osteoarthritis is significantly different with regions, age and sex.
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Affiliation(s)
- Jingkai Di
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiang Bai
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Junrui Zhang
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaoyang Chen
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuxuan Hao
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaqi Bai
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chuan Xiang
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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Meek JY, Noble L. Technical Report: Breastfeeding and the Use of Human Milk. Pediatrics 2022; 150:188348. [PMID: 35921641 DOI: 10.1542/peds.2022-057989] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 01/12/2023] Open
Abstract
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding or the provision of human milk a public health imperative. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond. These recommendations are consistent with those of the World Health Organization (WHO). Medical contraindications to breastfeeding are rare. The AAP recommends that birth hospitals or centers implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity. The Centers for Disease Control and Prevention and The Joint Commission monitor breastfeeding practices in United States hospitals. Pediatricians play a critical role in hospitals, their practices, and communities as advocates of breastfeeding and, thus, need to be trained about the benefits of breastfeeding for mothers and children and in managing breastfeeding. Efforts to improve breastfeeding rates must acknowledge existing disparities and the impact of racism in promoting equity in breastfeeding education, support, and services.
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Affiliation(s)
- Joan Younger Meek
- Department of Clinical Sciences, Florida State University College of Medicine, Orlando, Florida
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York.,New York City Health+Hospitals Elmhurst
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Costantini C, Joyce A, Britez Y. Breastfeeding Experiences During the COVID-19 Lockdown in the United Kingdom: An Exploratory Study Into Maternal Opinions and Emotional States. J Hum Lact 2021; 37:649-662. [PMID: 34496657 PMCID: PMC8641027 DOI: 10.1177/08903344211026565] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/30/2021] [Accepted: 05/27/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The COVID-19 pandemic has hugely impacted upon people's psychological and physical wellbeing; however, the effects of the COVID-19 lockdown on mothers of young children, with particular regard to breastfeeding, are unknown. RESEARCH AIMS To explore: (1) Sources of advice and support available to breastfeeding mothers during and prior to the COVID-19 lockdown; (2) Mothers' opinions on statements and recommendations made by the World Health Organization on the importance of breastfeeding and breastfeeding during the COVID-19 pandemic; (3) Maternal emotional states (i.e., anxiety and depression symptoms) experienced by breastfeeding mothers during the COVID-19 lockdown; and (4) influence of breastfeeding duration and number of children on breastfeeding opinions and emotional states. METHODS Mothers of children aged 0-36 months (N = 4018) took part in an online survey. The survey included demographic questions, as well as the Generalised Anxiety Disorder Questionnaire and the Patient Health Questionnaire. Mothers were further probed on opinions regarding breastfeeding practices during the COVID-19 pandemic. RESULTS Participants strongly agreed with the importance of breastfeeding, even if a mother showed symptoms of COVID-19. Differences in opinions on breastfeeding practices (e.g., the use of donor human milk and relactation), were found between participants in relation to breastfeeding duration and number of children. Participants with more than one child showed higher negative emotional states, namely anxiety symptoms. Except for Internet usage, participants indicated a decline in all sources of advice and support for breastfeeding during the COVID-19 lockdown. CONCLUSIONS Health bodies and professionals should consider maternal viewpoints and opinions regarding breastfeeding during the COVID-19 pandemic. Interventions are urgently needed in order to support breastfeeding mothers and prevent the development of mental health issues.
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Affiliation(s)
| | - Anna Joyce
- School of Psychotherapy and Psychology, Regent’s University London, UK
| | - Yolanda Britez
- School of Psychotherapy and Psychology, Regent’s University London, UK
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Panahi N, Ostovar A, Fahimfar N, Gharibzadeh S, Shafiee G, Heshmat R, Raeisi A, Nabipour I, Larijani B, Ghasem-Zadeh A. Grand multiparity associations with low bone mineral density and degraded trabecular bone pattern. Bone Rep 2021; 14:101071. [PMID: 33997148 PMCID: PMC8102397 DOI: 10.1016/j.bonr.2021.101071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 01/23/2023] Open
Abstract
Introduction Pregnancy is associated with changes in bone remodeling and calcium metabolism, which may increase the risk of fragility fracture after menopause. We hypothesized that in postmenopausal women, with history of grand multiparity, the magnitude of trabecular bone deterioration is associated with number of deliveries. Methods 1217 women aged 69.2 ± 6.4 years, from the Bushehr Elderly Health (BEH) program were recruited. The areal bone mineral density (aBMD) of the lumbar spine and femoral neck and trabecular bone score (TBS) of 916 postmenopausal women, with grand multiparity defined as more than 4 deliveries, were compared with those of 301 postmenopausal women with 4 or fewer deliveries. The association of multiparity with aBMDs and TBS were evaluated after adjustment for possible confounders including age, years since menopause, body mass index, and other relevant parameters. Results The aBMD of femoral neck (0.583 ± 0.110 vs. 0.603 ± 0.113 g/cm2), lumbar spine (0.805 ± 0.144 vs. 0.829 ± 0.140 g/cm2) and TBS (1.234 ± 0.086 vs. 1.260 ± 0.089) were significantly lower in women with history of grand multiparity than others. In the multiple regression analysis, after adjusting for confounders, the negative association did persist for lumbar spine aBMD (beta = −0.02, p value = 0.01), and the TBS (beta = −0.01, p value = 0.03), not for femoral neck aBMD. Conclusion We infer that grand multiparity have deleterious effects on the aBMD and the trabecular pattern of the lumbar spine.
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Affiliation(s)
- Nekoo Panahi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghasem-Zadeh
- Department of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia
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Yoo JE, Shin DW, Han K, Kim D, Yoon JW, Lee DY. Association of Female Reproductive Factors With Incidence of Fracture Among Postmenopausal Women in Korea. JAMA Netw Open 2021; 4:e2030405. [PMID: 33404618 PMCID: PMC7788464 DOI: 10.1001/jamanetworkopen.2020.30405] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Although estrogen level is positively associated with bone mineral density, there are limited data on the risk of fractures after menopause. OBJECTIVE To investigate whether female reproductive factors are associated with fractures among postmenopausal women. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used data from the Korean National Health Insurance Service database on 1 272 115 postmenopausal women without previous fracture who underwent both cardiovascular and breast and/or cervical cancer screening from January 1 to December 31, 2009. Outcome data were obtained through December 31, 2018. EXPOSURES Information was obtained about reproductive factors (age at menarche, age at menopause, parity, breastfeeding, and exogenous hormone use) by self-administered questionnaire. MAIN OUTCOMES AND MEASURES Incidence of any fractures and site-specific fractures (vertebral, hip, and others). RESULTS Among the 1 272 115 participants, mean (SD) age was 61.0 (8.1) years. Compared with earlier age at menarche (≤12 years), later age at menarche (≥17 years) was associated with a higher risk of any fracture (adjusted hazard ratio [aHR], 1.24; 95% CI, 1.17-1.31) and vertebral fracture (aHR, 1.42; 95% CI, 1.28-1.58). Compared with earlier age at menopause (<40 years), later age at menopause (≥55 years) was associated with a lower risk of any fracture (aHR, 0.89; 95% CI, 0.86-0.93), vertebral fracture (aHR, 0.77; 95% CI, 0.73-0.81), and hip fracture (aHR, 0.88; 95% CI, 0.78-1.00). Longer reproductive span (≥40 years) was associated with lower risk of fractures compared with shorter reproductive span (<30 years) (any fracture: aHR, 0.86; 95% CI, 0.84-0.88; vertebral fracture: aHR, 0.73; 95% CI, 0.71-0.76; and hip fracture: aHR, 0.87; 95% CI, 0.80-0.95). Parous women had a lower risk of any fracture than nulliparous women (aHR, 0.96; 95% CI, 0.92-0.99). Although breastfeeding for 12 months or longer was associated with a higher risk of any fractures (aHR, 1.05; 95% CI, 1.03-1.08) and vertebral fractures (aHR, 1.22; 95% CI, 1.17-1.27), it was associated with a lower risk of hip fracture (aHR, 0.84; 95% CI, 0.76-0.93). Hormone therapy for 5 years or longer was associated with lower risk of any factures (aHR, 0.85; 95% CI, 0.83-0.88), while use of oral contraceptives for 1 year or longer was associated with a higher risk of any fractures (aHR, 1.03; 95% CI, 1.01-1.05). CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that female reproductive factors are independent risk factors for fracture, with a higher risk associated with shorter lifetime endogenous estrogen exposure. Interventions to reduce fracture risk may be needed for women at high risk, including those without osteoporosis.
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Affiliation(s)
- Jung Eun Yoo
- Healthcare System Gangnam Center, Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Won Yoon
- Healthcare System Gangnam Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong-Yun Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kim MY, Kim HJ, Noh JH, Kim SA, Hwang DS, Lee CH, Ha IH. Relationship of breastfeeding duration with joint pain and knee osteoarthritis in middle-aged Korean women: a cross-sectional study using the Korea National Health and Nutrition Examination Survey. BMC WOMENS HEALTH 2020; 20:213. [PMID: 32972416 PMCID: PMC7517693 DOI: 10.1186/s12905-020-01078-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/17/2020] [Indexed: 11/21/2022]
Abstract
Background The effect of joint health on the quality of life of middle-aged and older women is becoming more widely recognized with the aging of the world’s population. However, the association of long-term breastfeeding with joint pain and knee osteoarthritis has not been fully examined. The aim of this study was to determine the association of prior breastfeeding duration with current joint pain and knee osteoarthritis in middle-aged Korean women. Methods This cross-sectional study was conducted among 3454 women aged ≥50 years who underwent knee radiography and answered a questionnaire on breastfeeding and joint pain for the 5th Korea National Health and Nutrition Examination Survey (2010–2011). After adjusting for confounding sociodemographic, medical history, and obstetric and gynecologic variables, logistic regression analysis was conducted to analyze the prevalence of joint pain and knee osteoarthritis according to breastfeeding and its duration. Results Among the 3454 participants, 298 had not breastfed and 1042, 815, and 1299 had breastfed for 1–24, 25–48, and ≥ 49 months, respectively. Of all participants, 1731 had joint pain and 739 were diagnosed with knee osteoarthritis after radiography. Using the non-breastfeeding group as a reference, the odds ratio (OR) for joint pain among women who breastfed ≥1 month was 1.49 (95% confidence interval [CI] 1.01–2.21). As the breastfeeding duration increased, the OR of joint pain prevalence also increased (p for trend; p = 0.002). For knee osteoarthritis, the OR was 2.30 in the 25–48 months group (95% CI 1.09–4.86). The OR of knee osteoarthritis in the ≥49 months group was 2.17 (95% CI 1.01–4.64). Sensitivity analysis after selecting only participants aged ≥60 years showed that the prevalence of joint pain and knee osteoarthritis was more positively correlated with extended breastfeeding duration (joint pain, p for trend; p = 0.005) (knee osteoarthritis, p for trend; p = 0.012). Conclusions Long-term feeding for more than 25 months was associated with an increased prevalence of joint pain and degenerative arthritis in Korean women aged ≥50 years.
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Affiliation(s)
- Min-Young Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Hyun-Joong Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Je-Heon Noh
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Sun-A Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Deok-Sang Hwang
- Department of Korean Medicine Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Chang-Hoon Lee
- Department of Korean Medicine Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F JS tower, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
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Dimnjakovic J, Poljicanin T, Svajda M. Breastfeeding: A standard or an intervention? Review of systematic reviews. Med Hypotheses 2020; 141:109737. [DOI: 10.1016/j.mehy.2020.109737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
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Yilak G, Gebretsadik W, Tadesse H, Debalkie M, Bante A. Prevalence of ineffective breastfeeding technique and associated factors among lactating mothers attending public health facilities of South Ari district, Southern Ethiopia. PLoS One 2020; 15:e0228863. [PMID: 32045451 PMCID: PMC7012449 DOI: 10.1371/journal.pone.0228863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/25/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Improper positioning, attachment, and suckling are constructs for ineffective breastfeeding technique (IBT). IBT results in inadequate intake of breast milk, which leads to poor weight gain, stunting, and declines immunity. Besides, IBT increases the risk of postpartum breast problems. Despite its impact on maternal and child health, breastfeeding technique is not well studied in Ethiopia. Hence, the purpose of this study was to assess the prevalence of IBT and associated factors among lactating mothers attending public health facilities of South Ari district, Southern Ethiopia. Materials and methods An institution-based cross-sectional study was conducted among 415 lactating mothers attending public health facilities of South Ari district from March 1-29, 2019. A structured observational checklist and interviewer-administered questionnaires were used. Bivariable and multivariable analyses were carried out using binary logistic regression to assess the association between explanatory variables and IBT. Statistical significance was declared at p-value < 0.05. Results Overall, the prevalence of IBT was 63.5% [95% confidence interval (CI); 59.0%, 68.0%]. Having no formal education [adjusted odds ratio (AOR): 5.0, 95% CI: 2.3, 10.5], delivering at home [AOR: 4.5; 95% CI; 1.6, 13.1], having breast problems [AOR: 2.5, 95% CI: 1.1, 5.7], being primiparous [AOR: 1.8, 95% CI: 1.0, 3.2], not receiving counseling during pregnancy and postnatal period [AOR: 2.3, 95% CI: 1.4, 3.9 and AOR: 2.5, 95% CI: 1.3, 5.1 respectively] were significantly associated with IBT. Conclusion IBT was very high in the study area. Thus, empowering women, increasing institutional delivery, and providing continuous counseling about breastfeeding throughout the maternal continuum of care is invaluable to improve breastfeeding techniques.
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Affiliation(s)
- Gizachew Yilak
- Department of Nursing, College of Medicine and Health Sciences, Mizan Tepi University, Mizan, Ethiopia
| | - Woiynshet Gebretsadik
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Hiwot Tadesse
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Megbaru Debalkie
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Agegnehu Bante
- Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail:
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Determinants of Continued Breastfeeding at 12 and 24 Months: Results of an Australian Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203980. [PMID: 31635280 PMCID: PMC6843256 DOI: 10.3390/ijerph16203980] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 12/14/2022]
Abstract
Breastfeeding to 12 months and beyond offers considerable health benefits to both infants and mothers. Despite these recognized benefits, relatively few women in high income countries breastfeed for 12 months, and rarely breastfeed to 24 months. The aim of this study was to identify the prevalence and determinants of continued breastfeeding to 12 and 24 months amongst a cohort of Australian women participating in the Adelaide-based Study of Mothers' and Infants' Life Events affecting oral health (SMILE). Duration of breastfeeding was known for 1450 participants and was derived from feeding related data collected at birth, 3, 6, 12 and 24 months. Multivariable logistic regression analysis was used to investigate the relationship between explanatory variables and continued breastfeeding to 12 and 24 months. In total, 31.8% of women breastfed to 12 months and 7.5% to 24 months. Women who were multiparous, university educated, had not returned to work by 12 months and whose partners preferred breastfeeding over bottle feeding were more likely to be breastfeeding at 12 months. While women who had introduced complementary foods before 17 weeks and formula at any age were less likely to be breastfeeding at 12 months. Mothers who were born in Asian countries other than India and China, had not returned to work by 12 months and had not introduced formula were more likely to be breastfeeding at 24 months. The majority of the determinants of continued breastfeeding are either modifiable or could be used to identify women who would benefit from additional breastfeeding support and encouragement.
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Lee EN, Choe SY, Choi EH, Lee MJ. Effects of Parity and Breast Feeding Duration on the Risk of Osteoporosis in Postmenopausal Korean Women: A Systematic Review and Meta-Analysis. J Menopausal Med 2019; 25:100-107. [PMID: 31497580 PMCID: PMC6718649 DOI: 10.6118/jmm.19197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/29/2019] [Accepted: 06/24/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives To summarize the evidence regarding the association of parity and breast feeding duration with the risk of osteoporosis in postmenopausal Korean women. This was because studies have been inconsistent regarding the effect of parity and breast feeding duration on the risk of osteoporosis. Methods A systematic literature search of relevant studies published by December 26, 2018 was conducted in PubMed, EMBASE, the Cochrane Library, CINAHL, RISS, KISS, KMbase, and KoreaMed. Outcome estimates of odds ratio (OR) or standardized mean difference were pooled with fixed or random-effect model. In case of heterogeneity, subgroup analysis was conducted. Results Seven cross-sectional studies (with 3,813 subjects) were included in the analysis. OR for osteoporosis was 1.43 (95% confidence interval [CI] = 1.09–1.88, P = 0.010) in postmenopausal women with higher parity compared to those with less parity. Moreover, OR for osteoporosis was 1.93 (95% CI = 1.28–2.93, P = 0.002) in postmenopausal women with longer durations of breast feeding than in those with shorter durations of breast feeding. Conclusions This study revealed that duration of breast feeding increased the risk of osteoporosis in postmenopausal Korean women. More cohort studies with high quality research designs are needed to confirm our results.
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Affiliation(s)
- Eun Nam Lee
- College of Nursing, Dong-A University, Busan, Korea
| | - Sun Yi Choe
- Department of Obstetrics & Gynecology, Dong-A University Hospital, Busan, Korea
| | - Eun Hui Choi
- Department of Nursing, Masan University, Masan, Korea
| | - Min Ju Lee
- College of Nursing, Dong-A University, Busan, Korea
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Yan G, Huang Y, Cao H, Wu J, Jiang N, Cao X. Association of breastfeeding and postmenopausal osteoporosis in Chinese women: a community-based retrospective study. BMC WOMENS HEALTH 2019; 19:110. [PMID: 31409345 PMCID: PMC6692954 DOI: 10.1186/s12905-019-0808-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/01/2019] [Indexed: 12/30/2022]
Abstract
Background Postmenopausal osteoporosis (PMOP) has long been a pervasive public health concern. With the aging Chinese population, the prevention, assessment and management of postmenopausal osteoporosis were particularly important. During the breastfeeding, a large amount of Calcium loss from maternal bone for infants’ growth. However, whether this loss is completely reversible remains controversial. As the relationship between breastfeeding and postmenopausal osteoporosis is different from society to society and is not clear from the literature, the purpose of this study was to determine whether breastfeeding was an independent factor for the development of PMOP based on Chinese postmenopausal population. Methods A retrospective cross-sectional investigation was conducted at Tianjin Xiaobailou health Community Healthcare Center between December 2017 and June 2018. Postmenopausal women over the age of 50 who underwent the annual health examination or visited the center to perform bone densitometry as a part of routine screening for disease were recruited. A trained community nurse administered a questionnaire to all participants by face-to-face interview. Participants were questioned about age, BMI, Vitamin D and calcium intake, the history of smoking, drinking and fracture, age of menarche, age of menopause, the number of pregnancy, parity, feeding pattern (breastfeeding, artificial feeding and mixed feeding) and overall breastfeeding duration. BMD measurements were carried out using quantitative ultrasound (QUS) at the bilateral radius. Results A total of 202 women who met the inclusive and exclusive criteria were enrolled. Univariate analysis revealed that overall breastfeeding more than 24 months increased the risk of osteoporosis (OR 39.00, 95%CI 2.40–634.65, p = 0.010). However, multivariate estimate of the risk of osteoporosis by overall breastfeeding duration suggested that when controlling for age, BMI, the number of pregnancy and parity, the overall breastfeeding duration was not an independent risk factor for postmenopausal osteoporosis (OR 5.22, 95%CI 0.18–147.76, p = 0.333). Additionally, age (OR 1.16, 95%CI 1.05–1.29, p = 0.003), BMI (OR 1.26, 95%CI 1.04–1.54, p = 0.021) and the number of pregnancy (OR 1.80, 95%CI 1.08–2.98, p = 0.024) were significant associated with postmenopausal osteoporosis. Conclusion Breastfeeding was not associated with postmenopausal osteoporosis, while age, BMI and the number of pregnancy may contribute to increasing risk of postmenopausal osteoporosis in Chinese women. Electronic supplementary material The online version of this article (10.1186/s12905-019-0808-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guiming Yan
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China.
| | - Yaqi Huang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Hong Cao
- Department of bone medicine of Tianjin Hospital, Tianjin, China
| | - Jie Wu
- Xiao Bai Lou Community Healthcare Service Center, Heping district, Tianjin, China
| | - Nan Jiang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Xiaona Cao
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
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Binns C, Yun Low W. The Emerging Silver Society in the Asia Pacific Region. Asia Pac J Public Health 2018; 30:92-94. [PMID: 29562787 DOI: 10.1177/1010539518763633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Colin Binns
- 1 School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Wah Yun Low
- 2 Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Li C, Wang Q. Meta-analysis of hypertension and osteoporotic fracture risk in women and men: response to comments by Rodríguez et al. Osteoporos Int 2018; 29:259-260. [PMID: 28986610 DOI: 10.1007/s00198-017-4245-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 09/24/2017] [Indexed: 12/12/2022]
Affiliation(s)
- C Li
- Department of Epidemiology and Biostatistics, MOE, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Q Wang
- Department of Epidemiology and Biostatistics, MOE, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Li X, Gong X, Jiang W. Abdominal obesity and risk of hip fracture: a meta-analysis of prospective studies. Osteoporos Int 2017; 28:2747-2757. [PMID: 28702682 DOI: 10.1007/s00198-017-4142-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/30/2017] [Indexed: 01/20/2023]
Abstract
UNLABELLED We conducted a meta-analysis to qualitatively summarize the evidence of the association between abdominal obesity and hip fracture risk. The results indicated that abdominal obesity as measured by waist circumference and waist-hip ratio might be associated with an increased risk of hip fracture. INTRODUCTION Epidemiological investigations evaluating the association of abdominal obesity with hip fracture risk have yielded conflicting results. Therefore, a meta-analysis was conducted to qualitatively summarize the evidence of the associations between waist circumference, waist-hip ratio, and hip circumference and the risk of hip fracture, respectively. METHODS PubMed, Embase, and Web of Science were searched for relevant articles published up to March 2017. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. Dose-response relationship was assessed by restricted cubic spline. RESULTS Seven studies involving 180,600 participants for hip circumference, six studies involving 199,828 participants for waist-hip ratio, and five studies involving 170,796 participants for waist circumference were finally included in this meta-analysis. The combined RRs with 95% CIs of hip fracture for the highest versus lowest category of waist circumference, waist-hip ratio, and hip circumference were 1.58 (95% CI 1.20-2.08), 1.32 (95% CI 1.15-1.52), and 0.87 (95% CI 0.74-1.02), respectively. For dose-response analysis, a nonlinear relationship was found (P nonlinearity < 0.001) between waist circumference and the risk of hip fracture, and a linear relationship (P nonlinearity = 0.911) suggested that the risk of hip fracture increased about 3.0% (1.03 (1.01-1.04)) for each 0.1 unit increment of waist-hip ratio. CONCLUSIONS This meta-analysis suggested that abdominal obesity as measured by waist circumference and waist-hip ratio might be associated with an increased risk of hip fracture. From a public health perspective, indicators of abdominal obesity may be usable predictors of hip fracture risk.
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Affiliation(s)
- X Li
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, China
| | - X Gong
- Surgical Department, Songshan Hospital of Qingdao University, No. 38 Dengzhou Road, Qingdao, Shandong, 266021, China
| | - W Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, China.
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Cooke-Hubley S, Kirby BJ, Valcour JE, Mugford G, Adachi JD, Kovacs CS. Spine bone mineral density increases after 6 months of exclusive lactation, even in women who keep breastfeeding. Arch Osteoporos 2017; 12:73. [PMID: 28815389 DOI: 10.1007/s11657-017-0368-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/07/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED This pilot study enrolled 31 women who had breastfed exclusively for 6 months. Lumbar and thoracic BMD increased 4 and 5%, respectively. Femoral neck and total body BMD did not change. Return of menses and progestin-only pill use were two potential signals that predicted a greater increase in BMD. PURPOSE/INTRODUCTION The skeleton is resorbed during lactation to provide much of the calcium content of milk. After lactation ceases, these deficits in skeletal mineral content are largely restored, such that lactation has a neutral or protective effect against the long-term risk of low bone mineral density (BMD), osteoporosis, and fragility fractures. We hypothesized that a large observational study may identify the factors that predict a greater increase in BMD after lactation ceases. A pilot study was first needed to test feasibility and the magnitude of expected BMD change. METHODS We undertook Factors Affecting Bone formation after Breastfeeding Pilot (FABB Pilot), which enrolled women who had breastfed exclusively for 6 months and planned to wean soon. The main outcome was change in BMD between enrolment and 6 months later. RESULTS Thirty-one women were recruited and completed both time points. Lumbar and thoracic spine BMD increased 4 and 5%, respectively; there was no significant change in femoral neck and total body BMD. Most women did not wean their babies as planned but continued to breastfeed multiple times per day. Despite this, a significant increase in BMD was seen in the subsequent 6 months. Return of spontaneous menses and use of a progestin-only pill at recruitment were two potential signals that predicted a greater increase in BMD during the 6 months after exclusive lactation. CONCLUSIONS Spine BMD increased significantly during 6 months following exclusive lactation and despite continued lactation. The factors that stimulate skeletal recovery remain to be identified.
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Affiliation(s)
- Sandra Cooke-Hubley
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Beth J Kirby
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - James E Valcour
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Gerald Mugford
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jonathan D Adachi
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Christopher S Kovacs
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada. .,Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
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