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Nie J, Li Y, Wang N, Liu Y, Wu J, Ye J, Reheman Z, Yang J, Xue H, Shi Y. Mothers' Gender-role Ideologies and Exclusive Breastfeeding in Western Rural China: A Cross-Sectional Study. J Hum Lact 2025; 41:70-81. [PMID: 39727000 DOI: 10.1177/08903344241300302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2024]
Abstract
BACKGROUND Shifts in women's maternal roles may contribute to the global low prevalence of exclusive breastfeeding. RESEARCH AIM To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China. METHODS Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding. RESULTS The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding (OR = 1.34, 95% CI [1.04, 1.72]), particularly for female infants (OR = 1.63, 95% CI [1.09, 2.43]). Furthermore, women with stronger egalitarian gender-role ideologies were found to exhibit a greater propensity for financial investment in their children (Beta = 0.20, 95% CI [0.01, 0.40]) and hold higher educational expectations for their daughters (OR = 1.50, 95% CI [1.00, 2.25]). CONCLUSION Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.
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Affiliation(s)
- Jingchun Nie
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Yangyuan Li
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Nan Wang
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Yunjie Liu
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Junhao Wu
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Jinbiao Ye
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Zulihumaer Reheman
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Jie Yang
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Hao Xue
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
| | - Yaojiang Shi
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, China
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Samsonsen C, Karanauskaitė U, Stenbacka EJ, Hjelvik ES, Rektorli L, Brodtkorb E. Pregnancy planning in women with epilepsy: A single center observational study with focus on epilepsy type. Seizure 2024; 123:152-158. [PMID: 39577168 DOI: 10.1016/j.seizure.2024.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 11/06/2024] [Accepted: 11/16/2024] [Indexed: 11/24/2024] Open
Abstract
PURPOSE To explore various aspects of pregnancy planning in women with epilepsy and to identify factors needing particular attention in the counselling of these patients with focus on epilepsy type. METHODS 285 pregnancies in 192 women were collected from the EURAP registry in Trondheim, Norway. Medical records were reviewed to validate diagnoses and types of epilepsy according to revised ILAE classifications. RESULTS Ten women proved to have non-epileptic conditions, leaving 274 pregnancies in 182 patients for inclusion. In 40 %, the epilepsy was focal, in 45 % generalized, including 18 % with JME. In 14 %, the epilepsy type was unknown. Pregnancies were planned in 64 %; 16 % were unintended and 20 % undetermined. Unintended pregnancies occurred in 15 % with focal and in 17 % with generalized epilepsy and in only 10 % of the JME subgroup. Planned pregnancy was associated with both preconception folic acid intake (p < 0.001) and breastfeeding ≥6 months (p = 0.011). Epilepsy of unknown type had the lowest rates of intended pregnancy and folic acid use. CONCLUSION We found no difference in pregnancy planning between focal and generalized epilepsy. Intended pregnancy was strongly associated with both folic acid and breastfeeding. The JME subgroup did not perform worse but rather above average regarding family planning and breastfeeding. The lowest proportion of folic acid intake was found in epilepsy of unknown type in which seizure control is common, and patients may receive less attention from the specialist health service. Appropriate counselling regarding pregnancy should reach out to all fertile women regardless of epilepsy type and seizure control.
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Affiliation(s)
- Christian Samsonsen
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Urtė Karanauskaitė
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Emma J Stenbacka
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ester S Hjelvik
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway
| | - Lene Rektorli
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway
| | - Eylert Brodtkorb
- Department of Neurology and Clinical Neurophysiology, St. Olav University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Brani P, Mrvoljak-Theodoropoulou I, Pechlivani F, Iliadou M, Antoniou E, Daskalakis G, Drakakis P, Dagla M. Breastfeeding Intention and Breastfeeding Postpartum Outcomes between High-Risk and Low-Risk Pregnant Women: A Greek Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:755. [PMID: 38929000 PMCID: PMC11204224 DOI: 10.3390/ijerph21060755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group. METHODS The study was conducted in one of the largest public hospitals in Attica that provides care to pregnant women, enrolling 380 participants divided into high-risk (n = 200) and low-risk (n = 180) cohorts. Data were collected over 20 months (starting from the end of May 2020 until January 2022), spanning from pregnancy to six months postpartum, via comprehensive questionnaires. RESULTS Statistical analysis revealed a pronounced correlation between prenatal breastfeeding intentions and actual breastfeeding behaviors across both groups. Specifically, 81.1% of women in the high-risk group and 82.5% in the low-risk group expressed intentions of exclusively breastfeeding during pregnancy. By six months postpartum, 54.9% of the high-risk and 64.3% of the low-risk pregnancy group managed to sustain breastfeeding. Extended antenatal hospitalization emerged as a statistically significant factor (p = 0.045) negatively impacting exclusive breastfeeding intentions among high-risk pregnancies. CONCLUSION The findings illuminate the critical influence of antenatal intentions on breastfeeding outcomes, particularly among high-risk pregnancies. Moreover, the study identifies the detrimental effect of prolonged hospital stays on breastfeeding aspirations. These insights underscore the necessity for nuanced, supportive interventions aimed at bolstering breastfeeding rates, thereby advancing maternal and neonatal health objectives aligned with World Health Organization recommendations.
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Affiliation(s)
- Panagiota Brani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | | | - Fani Pechlivani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Georgios Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Peter Drakakis
- Third Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
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Forthun IH, Roelants M, Haug LS, Knutsen HK, Schell LM, Jugessur A, Bjerknes R, Sabaredzovic A, Bruserud IS, Juliusson PB. Levels of per- and polyfluoroalkyl substances (PFAS) in Norwegian children stratified by age and sex - Data from the Bergen Growth Study 2. Int J Hyg Environ Health 2023; 252:114199. [PMID: 37295275 DOI: 10.1016/j.ijheh.2023.114199] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND AIM Due to the persistence, bioaccumulation and potential adverse health effects, there have been restrictions and phase out in the production of certain per- and polyfluoroalkyl substances (PFAS) since the early 2000s. Published serum levels of PFAS during childhood are variable and may reflect the impact of age, sex, sampling year and exposure history. Surveying the concentrations of PFAS in children is vital to provide information regarding exposure during this critical time of development. The aim of the current study was therefore to evaluate serum concentrations of PFAS in Norwegian schoolchildren according to age and sex. MATERIAL AND METHODS Serum samples from 1094 children (645 girls and 449 boys) aged 6-16 years, attending schools in Bergen, Norway, were analyzed for 19 PFAS. The samples were collected in 2016 as part of the Bergen Growth Study 2. Statistical analyses included Student t-test, one-way ANOVA and Spearman's correlation analysis of log-transformed data. RESULTS Of the 19 PFAS examined, 11 were detected in the serum samples. Perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid (PFHxS) and perfluorononaoic acid (PFNA) were present in all samples with geometric means of 2.67, 1.35, 0.47 and 0.68 ng/mL, respectively. In total, 203 children (19%) had PFAS levels above the safety limits set by the German Human Biomonitoring Commission. Significantly higher serum concentrations were found in boys compared to girls for PFOS, PFNA, PFHxS and perfluoroheptanesulfonic acid (PFHpS). Furthermore, serum concentrations of PFOS, PFOA, PFHxS and PFHpS were significantly higher in children under the age of 12 years than in older children. CONCLUSIONS PFAS exposure was widespread in the sample population of Norwegian children analyzed in this study. Approximately one out of five children had PFAS levels above safety limits, indicating a potential risk of negative health effects. The majority of the analyzed PFAS showed higher levels in boys than in girls and decreased serum concentrations with age, which may be explained by changes related to growth and maturation.
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Affiliation(s)
- Ingvild Halsør Forthun
- Department of Clinical Science, University of Bergen, Bergen, Norway; Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway.
| | - Mathieu Roelants
- Department of Public Health and Primary Care, Centre for Environment and Health KU Leuven, Leuven, Belgium
| | - Line Småstuen Haug
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway; Center for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway
| | - Helle Katrine Knutsen
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway; Center for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway
| | - Lawrence M Schell
- Department of Epidemiology and Biostatistics, University at Albany, Albany, NY, USA
| | - Astanand Jugessur
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Robert Bjerknes
- Department of Clinical Science, University of Bergen, Bergen, Norway; Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | | | - Ingvild Særvold Bruserud
- Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway; Faculty of Health, VID Specialized University, Bergen, Norway
| | - Petur Benedikt Juliusson
- Department of Clinical Science, University of Bergen, Bergen, Norway; Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway; Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway
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Silfverdal SA. Breast is best also in high-income countries. Acta Paediatr 2023; 112:11-13. [PMID: 36317733 DOI: 10.1111/apa.16579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022]
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Carlsen EØ, Magnus MC, Oakley L, Fell DB, Greve-Isdahl M, Kinge JM, Håberg SE. Association of COVID-19 Vaccination During Pregnancy With Incidence of SARS-CoV-2 Infection in Infants. JAMA Intern Med 2022; 182:825-831. [PMID: 35648413 PMCID: PMC9161123 DOI: 10.1001/jamainternmed.2022.2442] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Pregnant women are recommended to receive COVID-19 vaccination to reduce risk of severe COVID-19. Whether vaccination during pregnancy also provides passive protection to infants after birth remains unclear. OBJECTIVE To determine whether COVID-19 vaccination in pregnancy was associated with reduced risk of COVID-19 in infants up to age 4 months during COVID-19 pandemic periods dominated by Delta and Omicron variants. DESIGN, SETTING, AND PARTICIPANTS This nationwide, register-based cohort study included all live-born infants born in Norway between September 1, 2021, and February 28, 2022. EXPOSURES Maternal messenger RNA COVID-19 vaccination during second or third trimester compared with no vaccination before or during pregnancy. MAIN OUTCOMES AND MEASURES The risk of a positive polymerase chain reaction test result for SARS-CoV-2 during an infant's first 4 months of life by maternal vaccination status during pregnancy with either dose 2 or 3 was estimated, as stratified by periods dominated by the Delta variant (between September 1 and December 31, 2021) or Omicron variant (after January 1, 2022, to the end of follow-up on April 4, 2022). A Cox proportional hazard regression was used, adjusting for maternal age, parity, education, maternal country of birth, and county of residence. RESULTS Of 21 643 live-born infants, 9739 (45.0%) were born to women who received a second or third dose of a COVID-19 vaccine during pregnancy. The first 4 months of life incidence rate of a positive test for SARS-CoV-2 was 5.8 per 10 000 follow-up days. Infants of mothers vaccinated during pregnancy had a lower risk of a positive test compared with infants of unvaccinated mothers and lower risk during the Delta variant-dominated period (incidence rate, 1.2 vs 3.0 per 10 000 follow-up days; adjusted hazard ratio, 0.29; 95% CI, 0.19-0.46) compared with the Omicron period (incidence rate, 7.0 vs 10.9 per 10 000 follow-up days; adjusted hazard ratio, 0.67; 95% CI, 0.57-0.79). CONCLUSIONS AND RELEVANCE The results of this Norwegian population-based cohort study suggested a lower risk of a positive test for SARS-CoV-2 during the first 4 months of life among infants born to mothers who were vaccinated during pregnancy. Maternal COVID-19 vaccination may provide passive protection to young infants, for whom COVID-19 vaccines are currently not available.
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Affiliation(s)
- Ellen Øen Carlsen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Laura Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Deshayne B Fell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Jonas Minet Kinge
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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