Social correlates of term small for gestational age babies in a Russian arctic setting

BACKGROUND. Small for gestational age (SGA) births have been associated with both short- and long-term adverse health outcomes. Although social risk factors for SGA births have been studied earlier, such data are limited from Northern Russia. OBJECTIVE. We assessed maternal social risk factors for term SGA births based on data from the populationbased Murmansk County Birth Registry (MCBR). DESIGN. Data on term live-born singleton infants born between 2006 and 2011 in Murmansk County were obtained from the MCBR. We applied the 10th percentile for only birth weight (SGAW) or for both birth weight and birth length (SGAWL). Binary logistic regression was used to estimate the effect of independent variables on SGA males and females with adjustment for known risk factors and potential confounders. Both crude and adjusted odds ratios with 95% confidence intervals for the studied risk factors were calculated. RESULTS. The proportions of term SGAW and SGAWL births were 9.7 and 4.1%, respectively. After adjustment for potential confounders, the risk of term SGA births among less educated, unemployed, unmarried, smoking and underweight women was higher compared with women from the reference groups. Evidence of alcohol abuse was also associated with birth of SGAWL and SGAW boys. Maternal overweight and obesity decreased the risk of SGA. CONCLUSIONS. Maternal low education, unemployment, unmarried status, smoking, evidence of alcohol abuse and underweight increased the risk of term SGA births in a Russian Arctic setting. This emphasizes the importance of both social and lifestyle factors for pregnancy outcomes. Public health efforts to reduce smoking, alcohol consumption and underweight of pregnant women may therefore promote a decrease in the prevalence of SGA births.http://www.tandfonline.com/loi/zich20am2017School of Health Systems and Public Health (SHSPH

First-trimester smoking cessation in pregnancy did not increase the risk of preeclampsia/eclampsia : a Murmansk county birth registry study

BACKGROUND : Although prior studies have shown that smoking reduces preeclampsia/eclampsia risk, the consequence of giving up this habit during pregnancy should be assessed. The aims of the current study were threefold: (i) describe maternal characteristics of women with preeclampsia/ eclampsia; (ii) examine a possible association between the number of cigarettes smoked daily during pregnancy and the development of this affliction; and (iii) determine if first-trimester discontinuation of smoking during pregnancy influences the risk. METHODS : A registry-based study was conducted using data from the Murmansk County Birth Registry (MCBR). It included women without pre-existing hypertension, who delivered a singleton infant during 2006±2011 and had attended the first antenatal visit before 12 week of gestation. We adjusted for potential confounders using logistic regression. RESULTS : The prevalence of preeclampsia/eclampsia was 8.3% (95%CI: 8.0±8.6). Preeclampsia/ eclampsia associated with maternal age, education, marital status, parity, excessive weight gain and body mass index at the first antenatal visit. There was a dose-response relationship between the number of smoked cigarettes per day during pregnancy and the risk of preeclampsia/ eclampsia (adjusted OR1-5 cig/day = 0.69 with 95%CI: 0.56±0.87; OR6-10 cig/day = 0.65 with 95%CI: 0.51±0.82; and OR 11 cig/day = 0.49 with 95%CI: 0.30±0.81). There was no difference in this risk among women who smoked before and during pregnancy and those who did so before but not during pregnancy (adjusted OR = 1.10 with 95%CI: 0.91±1.32). CONCLUSIONS : Preeclampsia/eclampsia was associated with maternal age, education, marital status, parity, excessive weight gain, and body mass index at the first antenatal visit. There was a negative dose-response relationship between the number of smoked cigarettes per day during pregnancy and the odds of preeclampsia/eclampsia. However, women who gave up smoking during the first trimester of gestation had the same risk of preeclampsia/eclampsia as those who smoked while pregnant. Consequently, antenatal clinic specialists are advised to take these various observations into account when counselling women on smoking cessation during pregnancy.http://www.plosone.orgam2018School of Health Systems and Public Health (SHSPH

АНАЛИЗ ФАКТОРОВ, СВЯЗАННЫХ С ПРИВЕРЖЕННОСТЬЮ НАСЕЛЕНИЯ ВАКЦИНАЦИИ ПРОТИВ ВИРУСНОГО ГЕПАТИТА B В АРХАНГЕЛЬСКОЙ ОБЛАСТИ

To reveal factors associated with negative attitude to vaccination against viral hepatitis B we performed two crosssectional studies including 1243 adults aged 18–39 years, recruited by a public opinion agency applying a quota sampling method to achieve a data set with similar age- and sex-distribution as the population in Arkhangelsk, and 2896 parents, visiting child’s health-care facilities of Arkhangelsk region.Binary logistic regression was used to analyze factors associated with negative attitude to vaccination.Among 1243 adult respondents 3,5% expressed a negative attitude to vaccination against viral hepatitis B. According to serological testing 15,9% of participants who demonstrated negative attitude to vaccination had serological markers of viral hepatitis B infection (HBsAg, antiHBc-antibodies, sometimes in combination with antiHBs-antibodies). Respondents younger than 30 years and people who had standard risk factors of infection (injecting drug use, blood transfusion, surgery, induced abortions, tattoo, 5 and more sexual partners in a year), more often demonstrated positive attitude to vaccination against viral hepatitis B in comparison with others.Among 2896 parents 1,6% expressed a negative attitude to vaccination of their children against viral hepatitis B. Factors associated with negative attitude to vaccination were age younger than 25 years, high education, concerns and misinformation about vaccines, distrust in physicians.Thus, young adult people, who had standard risk factors of infection, had positive attitude to vaccination against viral hepatitis B. Young parents underestimated the risk of infection in children and importance of timely vaccination. The major reasons for negative public attitude to vaccination against viral hepatitis B were lack of information about vaccination and, as a consequence, unawareness of the need of immunization.С целью выявления факторов, определяющих приверженность населения вакцинации против вирусного гепатита В, проведено два поперечных исследования с участием 1243 человек от 18 до 39 лет, отобранных случайным образом с использованием базы данных мобильных телефонов жителей Архангельска, и 2896 родителей, посещающих лечебно-профилактические учреждения Архангельской области с целью профилактического осмотра или лечения своих детей.Оценка факторов, определяющих приверженность взрослого населения и родителей вакцинации против вирусного гепатита В, проводилась с использованием множественного логистического регрессионного анализа.Среди 1243 представителей взрослого населения 3,5% продемонстрировали негативное отношение к вакцинации против вирусного гепатита В. Согласно результатам серологического обследования на маркёры вирусного гепатита В, 15,9% участников, негативно относящихся к вакцинации, имели маркёры, свидетельствующие об инфицировании вирусом (HBsAg, antiHBcантитела, иногда в сочетании с antiHBs-антителами). Респонденты младше 30 лет, а также лица, имеющие стандартные факторы риска инфицирования ВГВ (инъекционные наркотики, гемотрансфузии, операции, искусственное прерывание беременности, татуировки, 5 и более половых партнёров в год), реже высказывали негативное отношение к вакцинации против данного заболевания.Среди 2896 родителей 1,6% сообщили о негативном отношении к вакцинации детей против вирусного гепатита В. Факторами, связанными с негативным отношением к вакцинации, были возраст родителя моложе 25 лет, высшее образование родителя, дезинформированность в отношении вакцинации, наличие сомнений в необходимости вакцинации, недоверие врачу.Таким образом, молодые взрослые, имеющие факторы риска инфицирования, позитивно относятся к проведению вакцинации против вирусного гепатита В. Молодые родители недооценивают риск инфицирования ребёнка и важность своевременного проведения прививки детям. Основными причинами негативного отношения к вакцинации против вирусного гепатита В являются недостаточная информированность населения и, как следствие, отсутствие мотивации к проведению прививок.

Correlates of low birth weight in term pregnancies: a retrospective study from Iran

<p>Abstract</p> <p>Background</p> <p>Low birth weight (LBW) is considered as a major multifaceted public health concern. Seventy-two percent of LBW infants are born in Asia. An estimation of 8% LBW infants has been reported for Eastern Mediterranean region including Iran. This study investigated contributory factors of LBW in singleton term births in Tehran, Iran. Tehran is a multicultural metropolitan area and a sample from the general population in Tehran could be regarded as a representative sample of urban population in Iran.</p> <p>Methods</p> <p>This was a retrospective study using data from 15 university maternity hospitals in Tehran, Iran. Data on all singleton term births in these hospitals were extracted from case records during a one calendar year. Study variables included: maternal age, maternal educational level, history of LBW deliveries, history of preterm labor, cigarette smoking during pregnancy, number of parities, chronic diseases and residential area (Tehran versus suburbs of Tehran). In order to examine the relationship between LBW and demographic and reproductive variables the adjusted logistic regression analysis was performed.</p> <p>Results</p> <p>In all, data for 3734 term pregnancies were extracted. The mean age of women was 25.7 (SD = 5.3) years and 5.2% of term births were LBW. In addition to association between LBW and maternal age, significant risk factors for LBW were: history of LBW deliveries [adjusted odds ratio (OR) = 2.53, 95% confidence interval (CI) = 1.06–6.03], smoking during pregnancy (OR = 4.64, 95% CI = 1.97–10.95) and chronic diseases (OR for hypertension = 3.70, 95% CI = 2.25–6.06, OR for others = 2.04, 95% CI = 1.09–3.83).</p> <p>Conclusion</p> <p>The findings indicate that in addition to maternal age, history of LBW deliveries; smoking during pregnancy and chronic diseases are significant determinants of LBW in this population. This is consistent with national and international findings indicating that maternal variables and risk behaviors during pregnancy play important roles on LBW.</p

Syphilis epidemiology in Norway, 1992-2008: resurgence among men who have sex with men

<p>Abstract</p> <p>Background</p> <p>In recent years, the number of syphilis cases has stabilised in many countries of Western Europe, however several countries have reported increases among men who have sex with men (MSM). The aim of this article was to describe the epidemiology of early syphilis in Norway in 1992-2008.</p> <p>Methods</p> <p>Cases of early syphilis and congenital syphilis reported to the Norwegian Surveillance System for Communicable Diseases (MSIS) 1992-2008 were described by route of transmission, gender, age, birthplace, stage of disease, HIV co-infection, source partner and place of infection.</p> <p>Results</p> <p>The incidence of reported syphilis ranged from 0.05 (1992) to 1.50 (2002) per 100 000 person-years. Of 562 cases reported to MSIS during the study period, 62% were men infected by another man. The proportion of those, infected homosexually increased from 0 (1992-1994) to 77% (2008). Most of them were Norwegians (83%). The proportion of HIV co-infection among homosexually infected increased over time and reached 39% in 2008. The majority reported being infected by a casual partner (73%) and in the municipality of Oslo (72%). Of 152 heterosexually infected men 64% were Norwegians; 51% were infected by casual contacts and 20% by commercial sex workers; 73% were infected abroad. Among 56 women, 57% were Norwegians, 57% were infected by a steady partner and 40% were infected abroad. Almost half (46%) were diagnosed in the early latent stage. Four cases had congenital syphilis, two of whom were adopted from abroad.</p> <p>Conclusions</p> <p>Syphilis is rare in Norway, but MSM represent almost two thirds of cases. The increase of HIV co-infected cases among MSM may enhance transmission of both infections. We recommend sexually active MSM to be tested for syphilis 2-4 times a year. Due to its variable clinical course, syphilis might be difficult to recognise at an early stage among women in a low-prevalence population. We estimate current practice of prenatal screening in Norway as sufficient.</p

Adherence to physical activity recommendations and the influence of socio-demographic correlates – a population-based cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Current physical activity guidelines acknowledge the importance of total health enhancing physical activity (HEPA) compared to leisure time physical activity or exercise alone. Assessing total HEPA may result in different levels of adherence to these as well as the strength and/or direction of associations observed between total HEPA and socio-demographic correlates. The aim of this study was to estimate the proportion of the population adhering to the recommendation of at least 30 minutes of HEPA on most days, and to examine the influences of socio-demographic correlates on reaching this recommendation.</p> <p>Methods</p> <p>Swedish adults aged 18–74 years (n = 1470) were categorized, based on population data obtained using the IPAQ, into low, moderately and highly physically active categories. Independent associations between the physical activity categories and socio-demographic correlates were studied using a multinomial logistic regression.</p> <p>Results</p> <p>Of the subjects, 63% (95% CI: 60.5–65.4) adhered to the HEPA recommendation. Most likely to reach the highly physical active category were those aged < 35 years (OR = 1.8; 95% CI: 1.1–3.3), living in small towns (OR = 1.8; 95% CI: 1.1–2.7) and villages (OR = 2.4; 95% CI: 1.6–3.7), having a BMI between 25.0–29.9 kg/m²(OR = 2.7; 95% CI: 1.4–5.3) having a BMI < 25 kg/m²(OR = 2.5; 95% CI: 1.3–4.9), or having very good (OR = 2.1; 95% CI: 1.3–3.3) or excellent self-perceived health (OR = 4.1; 95% CI: 2.4–6.8). Less likely to reach the high category were women (OR = 0.6; 95% CI: 0.5–0.9) and those with a university degree (OR = 0.5; 95% CI: 0.3–0.9). Similar, but less pronounced associations were observed for the moderate group. Gender-specific patterns were also observed.</p> <p>Conclusion</p> <p>Almost two-thirds of the Swedish adult population adhered to the physical activity recommendation. Due to a large diversity in levels of physical activity among population subgroups, social-ecological approaches to physical activity promotion may be warranted.</p

Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania

<p>Abstract</p> <p>Background</p> <p>Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a neonatal care unit (NCU) in data from a birth registry at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania.</p> <p>Methods</p> <p>A total of 21 206 singleton live births registered from 2000 to 2008 were included. Multivariable analysis was carried out to study neonatal transfer to NCU by socio-demographic factors, pregnancy complications and measures of the condition of the newborn.</p> <p>Results</p> <p>A total of 3190 (15%) newborn singletons were transferred to the NCU. As expected, neonatal transfer was strongly associated with specific conditions of the baby including birth weight above 4000 g (relative risk (RR) = 7.2; 95% confidence interval (CI) 6.5-8.0) or below 1500 g (RR = 3.0; 95% CI: 2.3-4.0), five minutes Apgar score less than 7 (RR = 4.0; 95% CI: 3.4-4.6), and preterm birth before 34 weeks of gestation (RR = 1.8; 95% CI: 1.5-2.1). However, pregnancy- and delivery-related conditions like premature rupture of membrane (RR = 2.3; 95% CI: 1.9-2.7), preeclampsia (RR = 1.3; 95% CI: 1.1-1.5), other vaginal delivery (RR = 2.2; 95% CI: 1.7-2.9) and caesarean section (RR = 1.9; 95% CI: 1.8-2.1) were also significantly associated with transfer. Birth to a first born child was associated with increased likelihood of transfer (relative risk (RR) 1.4; 95% CI: 1.2-1.5), while the likelihood was reduced (RR = 0.5; 95% CI: 0.3-0.9) when the father had no education.</p> <p>Conclusions</p> <p>In addition to strong associations between neonatal transfer and classical neonatal risk factors for morbidity and mortality, some pregnancy-related and demographic factors were predictors of neonatal transfer. Overall, transfer was more likely for babies with signs of poor health status or a complicated pregnancy. Except for a possibly reduced use of transfer for babies of non-educated fathers and a high transfer rate for first born babies, there were no signs that transfer was based on non-medical indications.</p

An exploration of the knowledge and attitudes towards breastfeeding among a sample of Chinese mothers in Ireland

<p>Abstract</p> <p>Background</p> <p>Psychological factors are important in influencing breastfeeding practices. This retrospective study explored knowledge and attitudes related to breastfeeding of Chinese mothers living in Ireland.</p> <p>Methods</p> <p>A cross-sectional self-administrated survey written in Chinese was distributed to a convenience sample of 322 immigrant Chinese mothers mainly <it>via </it>Chinese supermarkets and Chinese language schools in Dublin, with the involvement of the snowball method to increase sample size. Maternal breastfeeding knowledge and attitudes were described, their associations with socio-demographic variables were explored by Chi-square analysis, and their independent associations with breastfeeding behaviours were estimated by binary logistic regression analyses.</p> <p>Results</p> <p>In spite of considerable awareness of the advantages of breastfeeding (mean score = 4.03 ± 0.73), some misconceptions (<it>e</it>.<it>g</it>. 'mother should stop breastfeeding if she catches a cold') and negative attitudes (<it>e</it>.<it>g</it>. breastfeeding inconvenient, embarrassing, and adverse to mothers' figure) existed, especially among the less educated mothers. Cultural beliefs concerning the traditional Chinese postpartum diet were prevalent, particularly among those who had lived in Ireland for a shorter duration (P = 0.004). Psychological parameters had strong independent associations with breastfeeding practices in this study. Those who had lower awareness score (OR = 2.98, 95% CI: 1.87-4.73), more misconceptions and negative attitudes (P < 0.05), and weaker cultural beliefs (P < 0.05) were less likely to breastfeed.</p> <p>Conclusions</p> <p>Findings highlight a need to focus resources and education on correcting the misconceptions identified and reversing the negative attitudes towards breastfeeding among Chinese mothers in Ireland, in particular those with primary/secondary level of education. Mothers' cultural beliefs should also be acknowledged and understood by healthcare providers.</p