bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure of pre-school aged children to schistosomiasis: a call for public health strategies
Authors: Hameister J , Solonirina MJ , Rasamoelina T , Rakotozandrindrainy R , Rakotoarivelo R , Rausche P , Puradiredja DI , May J , Fusco D ,   freeBILy consortium
Published: October 2022

Background

Schistosomiasis is a disease of poverty, prevalent in tropical regions and emerging in Europe. Mass drug administration (MDA) is a common strategy to fight the disease. Pre-school aged children (PSAC) are conventionally considered not to be at high risk of infection and thus usually excluded from MDA. However, chronic infections at young ages can result in serious health consequences. Our study aims to better understand the schistosomiasis transmission routes in PSAC and risk perceptions among caretakers in the endemic context of Madagascar.

Methods

This is a cross-sectional sub-study embedded in the clinical trial freeBILy. Using a mixed methods approach, 86 women and their two-year-old children in four communities of the Amoron’ I Mania and Itasy regions of Madagascar in April 2022 were interviewed using structured questionnaires, focus group discussions and in-depth-interviews. Additionally, structured observational data were collected on the behaviours of 20 PSAC around waterbodies in the communities where notes and anonymised photos were taken.

Results

Preliminary analysis shows that knowledge of schistosomiasis, its transmission routes and effects is limited. Risky behaviours of children were reported during the observations. They joined their mothers during daily activities and spent between 3-60 mins in rivers, lakes and rice fields. The exposure time to potentially contaminated waters was sufficient to represent a risk for infection.

Conclusions

Even though our preliminary results show that PSAC are at risk of schistosomiasis infection, they are currently excluded from systematic public health interventions. The lack of risk awareness among caretakers in endemic countries calls for actions to establish tailored programs on health literacy and education. Treatment should be considered for PSAC as well as the implementation of awareness campaigns, both locally and globally given the re-occurrence of schistosomiasis in countries outside the tropics.

Key messages

• Pre-school aged children are exposed to the risk of early infection with schistosomiasis.

• Public health programs against schistosomiasis should address pre-school aged children in endemic countries and in health promotion strategies globally.
Safe Hands 3.0: new tool to prevent healthcare associated infection
Authors: Valero-Ubierna C , Perez deRojas J , Marin Caba E , Martinez Bellón D , Gutierrez Linares S
Published: October 2022

Background

Healthcare associated infection (HAI) is a Public Health problem. Hands of healthcare workers are a key for transmission. Compliance with WHO 5 moments for hand hygiene (HH) has been emphasized, but there are other aspects: appropriate use of gloves and healthy hands skin of professionals. Gloves protect the professionals but it may increase cross-transmission. Hands dermatitis is a handicap for the use of alcohol-based handrubs. Data collection and analysis, to have a good communication system to improve training, information and to get feedback from professionals are necessary. The aim of this work is to develop the Safe Hands 3.0 Project in a General Hospital.

Methods

Preventive Medicine and Public Health Department carried out a descriptive study carried out in a 477-bed General Hospital in last semester 2021. Compliance with HH and the possible causes of non-compliance were assessed with observations and knowledge surveys included appropriate use of gloves in healthcare practice and the impact on hand in professionals. The surveys were carried out using Lime Survey for mobile devices and Google for WhatsApp.

Results

From 550 observations of HH compliance for the WHO 5 moments is less than 40%. Half of non-compliance was due to inappropriate use of gloves. 266 surveys answered highlighting the need for continued training. Survey on hand skin health perception was answered by 182 professionals, 44% reported dermatological issues and 81% notice that their work damaged their hands skin. A corporate logo was created, use the hospital website and a structured Communication Plan for its implementation.

Conclusions

To prevent HAI transmission, the concept of Hand Hygiene is limited. Safe Hands 3.0 Project comes up with a bundle of care: proper use of gloves, compliance the WHO 5 moments and skin care of healthcare workers’ hands. Update data management and a corporate communication plan with social networks is necessary to improve training and compliance.

Key messages

• A bundle of care is the key for Safe Hands: proper use of gloves, compliance the WHO 5 moments and skin care of healthcare workers’ hands.

• Update data management and a corporate communication plan with social networks is necessary to improve training and compliance.
Flu immunization during pregnancy: a cross-sectional study among Italian healthcare providers
Authors: Licata F , Angelillo S , Della Polla G , Pelullo CP , Napolitano F , Di Giuseppe G , Romeo M , Bianco A
Published: October 2022

Background

Flu vaccination during pregnancy has been proven to be effective in preventing illness and hospitalization in both pregnant women and newborns. However, flu vaccination uptake is still suboptimal. The study aimed to assess if healthcare providers (HCPs) are knowledgeable about flu vaccination recommendation during pregnancy and if they routinely recommend the vaccination.

Methods

The present survey was carried out among obstetricians-gynaecologists (OBs), midwives and primary care physicians (PCPs) in the Southern part of Italy. Data were collected through an anonymous self-administered questionnaire that included professional information, knowledge, perceptions and practices on flu vaccination during pregnancy.

Results

96 participants were hitherto enrolled (36.5% OBs, 35.4% PCPs and 28.1% midwives). Among the responders, 63.5% and 66.7% knew that flu vaccination can be administrated during any trimester of pregnancy and reduces the risk of preterm birth and miscarriage, respectively. Alarmingly, more than a fifth (22.9%) of the sample believed that vaccines during pregnancy are more dangerous than safe and only 67.7% routinely recommend the flu vaccine to all women regardless of their stage in pregnancy. Among HCPs who did not recommend the flu shot, the most frequently reported reasons were that flu vaccine recommendation was outside the scope of their practice (62.5%), that women are more hesitant about vaccines during pregnancy (37.5%) and lack of time (25%).

Conclusions

The preliminary results highlight alarming gaps in knowledge (e.g. immunization timing) and suboptimal routine recommendation of the flu vaccine that represents a missed opportunity. Indeed, it has been demonstrated that when women are offered vaccination, most tend to accept it.

Key messages

• Unmotivated concerns about vaccine safety during pregnancy have to be addressed among HCPs to enhance flu recommendation and, subsequently, immunization coverage in pregnant women.

• Strategies to disseminate evidence-based recommendations to HCPs regarding flu immunization during pregnancy have to be implemented and evaluated in order to improve public health.
Impact of COVID-19 on flu vaccination among pregnant women in a Teaching Hospital in Rome
Authors: Nachira L , Bruno S , Carducci B , Villani L , Pascucci D , Quaranta G , Damiani G , Federico B , Lanzone A , Laurenti P
Published: October 2022

Background

According to WHO, UNICEF, GAVI and the Sabin Vaccine Institute data, the COVID-19 pandemic caused the disruption of routine vaccinations in at least 68 countries. In March ‘20, the WHO published a guide to help countries continuing their provision safely to prevent unnecessary visits and hospitalizations: especially flu vaccination is paramount to reduce respiratory illnesses and their burden on healthcare systems. For the flu season 2021-22, the Italian Ministry of Health recommended prioritizing flu vaccination for pregnant women. This study aims at comparing flu vaccination rates between pre-pandemic and pandemic periods in pregnant women attending a birthing preparation course at the Fondazione Policlinico Universitario A.Gemelli IRCCS (FPG) in Rome.

Methods

A repeated cross-sectional study was carried out in FPG during two flu epidemic seasons (October ‘19-January ‘20 and September ‘20-January ‘21), when two different cycles of birthing preparation courses were held (face-to-face and online, respectively). Pregnant women and their partners attending them were offered flu vaccination at FPG. A χ2 test was performed to compare vaccination rates, with statistical significance set at p = 0.05.

Results

In 2019-20, 48 out of 119 women and 39 men out of 119 attending the course accepted flu vaccination, while in 2020-21 they were respectively 88 out of 317 and 89 out of 317. Overall vaccination compliance among pregnant women was significantly higher in 2019-20 than in 2020-21 (40.3% and 27.8% respectively, p = 0.012), while the difference was not significant among their partners (32.8% and 28.1% respectively, p = 0.337).

Conclusions

The COVID-19 pandemic negatively affected flu vaccination adherence among the pregnant women involved. Fear of contagion and access to facilities closer to their home could be potential key drivers. These results represent an important warning on flu vaccination attitudes during the pandemic: more actions are needed to improve compliance.

Key messages

• COVID-19 might have hindered access to immunization services for at-risk populations, such as that of pregnant women.

• From a Public Health point of view, more actions are needed to harmonize interactions between hospitals and local national health services to improve vaccination compliance.
The impact of Covid-19 vaccines on fertility-A systematic review and metanalysis
Authors: Zaçe D , La Gatta E , Petrella L , Shukhovtseva A , Di Pietro ML
Published: October 2022

Introduction

Despite literature’s proofs about their safety, concerns arose regarding adverse events due to Covid-19 vaccines, including the possible impact on fertility, accentuated by misinformation and anti-vaccine campaigns. The aim of this study was to evaluate the Covid-19 vaccines’ impact on male and female fertility.

Methods

PubMed, Scopus, Web of Science, Cochrane and Embase databases were searched for eligible studies until March 7th, 2022. Primary studies investigating the Covid-19 vaccines impact on male and female fertility, were included. Studies’ quality was assessed by the Newcastle-Ottawa and the Before and After Quality Assessment scales for cohort and pre-post studies, respectively. Random-effect meta-analyses were performed for parameters considered in ≥ 2 studies, calculating means, p-values and 95% Confidence Intervals (CIs). I2 statistics was used to assess statistical heterogeneity.

Results

Out of 1406 studies screened, 20 studies were included in the systematic review. These studies, conducted in Israel (35%), USA (30%), Russia (25%), China (5%) and Italy (5%), were of poor (15%), moderate (75%) and good (10%) quality. Meta-analyses among five studies considering several vaccines were performed for pre- and post-vaccination sperm progressive motility ((49%, 95% CI 36-67% vs 49%, 95% CI 39-61%; p = 0.963) and concentration (64.39 mln/ml, 95% CI 47.51-87.28 and 72.00 mln/ml, 95% CI 51.22-101.21; p = 0.03). Subgroup meta-analyses based on the type of vaccine showed no significant difference: between vaccinated with mRNA vaccines and non-vaccinated regarding biochemical pregnancy rates; pre- and post-vaccination with Gam-COVID-Vac regarding testosterone, FSH and LH levels; pre- and post-vaccination with BNT162b2 vaccines regarding sperm volumes.

Discussion

There is no scientific proof of any association between Covid-19 vaccines and infertility in men or women. Misinformation and doubts about vaccines should be properly addressed.

Key messages

• The doubts regarding Covid-19 vaccines’ impact on both male and female fertility resulted to be unfounded. Covid-19 vaccines remain the most important weapon to fight the pandemic.

• It is important to keep providing to public opinion and health care providers evidence-based scientific information, in order to effectively combat misinformation and anti-vaccines campaigns.
Predicting low cognitive ability at age 5 using machine learning methods and birth cohort data
Authors: Bowe A , Staines A , McCarthy F , Lightbody G , Murray D
Published: October 2022

Background

Early intervention is essential to address disparities in cognitive development. Current developmental screening will not detect the vast majority of children who go on to have below average cognitive ability at school age. In this study, we applied the random forest (RF) algorithm, a highly interpretable machine learning method, to birth-cohort data to train a model to predict low cognitive ability at 5 years of age using perinatal features.

Methods

Data was from 1,070 participants in the Irish population-based BASELINE birth cohort. A RF model was trained to predict an intelligence quotient (IQ) score <90 at age 5 years using a broad selection of maternal, infant, birth, and sociodemographic features, all of which could be easily measured at a population level in the perinatal period. Feature importance was examined using mean decrease in Gini impurity, mean decrease in accuracy, and mean minimal depth. Recursive feature elimination was used to develop a parsimonious model. Internal validation was performed using 10-fold cross validation repeated 5 times.

Results

The most predictive features for low cognitive ability at 5 years of age were the total years of maternal schooling, infant Apgar score at 1 minute, socioeconomic index, maternal BMI, and units of alcohol consumed in the first trimester. A parsimonious RF model based on 11 features showed excellent predictive ability, with a sensitivity of 0.89 and a specificity of 0.98, providing a foundation suitable for external validation in an unseen cohort.

Conclusions

Machine learning approaches to large existing datasets can provide accurate feature selection to improve risk prediction. Further validation of this model is required in additional cohorts, representative of the general population. Accurate risk prediction can facilitate targeted screening and intervention.

Key messages

• The application of machine learning to large population-based data can improve feature selection and accuracy in risk prediction models.

• Accurate risk prediction may enable early intervention to address disparities in cognitive development. Individual interventions must occur in conjunction with population level policy changes.
Factors promoting or limiting self-determined childbirth: midwives’ perspectives in Germany
Authors: Tallarek M , Spallek J
Published: October 2022

Background

Claims for self-determined childbirth (SDC) have gained increasing scientific, political and societal attention. However, research on SDC is limited. This study analyzes and compares midwives’ experiences and perspectives on factors that promote or limit SDC in hospitals, birthing centers and during home births in Germany. We argue that these insights are essential in order to foster self-determination and to avoid its violation.

Methods

A qualitative case study was conducted based on semi-structured face-to-face interviews with midwives working in hospitals, birthing centers, and offering home births in Germany. In total, nine interviews were conducted in 2021 and have been audiotaped, transcribed, anonymized and analyzed by use of Thematic Analysis.

Results

The results indicate eight inter-related categories, each of which imply promoting and limiting factors: 1) Structural/ legal conditions; 2) Perception of birth (e. g. as natural or medical process; required competence and control); 3) Trust and atmosphere; 4) Getting acquainted/relationship building; 5) Birthing person’s socioeconomic position; 6) Birthing person’s preparation/ education; 7) Birthing person’s capability of decision making and expression; and 8) Behavior of accompanying persons. Moreover, we identified midwives’ strategies to extend possibilities of choice. Several factors clearly differ depending on the birth setting.

Conclusions

The opportunities for SDC seem to differ according to the setting (e.g. institutional routines), inter-personal relations (e.g. getting acquainted, trust), and individual factors (e.g. socioeconomic position, capabilities). Hence, political, institutional and individual strategies may support SDC in consideration of the above factors. Measures may, among others, include the improvement of information processes, the reduction of economic barriers, relationship building before and during birth as well as respective structural adjustments.

Key messages

• Self-determination (SD) in childbirth is influenced by several factors at individual, inter-personal, institutional and macro level.

• Individual, institutional and political strategies may support SD.
Factors associated with the closure of German obstetric units and its effects on accessibility
Authors: Hoffmann J , Scholten N , Dresbach T
Published: October 2022

Background

An increase in regionalization of obstetric services is being observed worldwide. This study investigated factors associated with the closure of obstetric units in hospitals in Germany and aimed to examine the effect of obstetric unit closure on accessibility of obstetric care.

Methods

Secondary data of all German hospital sites with an obstetrics department were analyzed for 2014 and 2019. Multivariate logistic regression was performed to identify factors associated with obstetrics department closure. Subsequently, the driving times to a hospital site with an obstetrics department were mapped, and different scenarios resulting from further regionalization were modelled.

Results

Of 747 hospital sites with an obstetrics department in 2014, 85 obstetrics departments closed down by 2019. Only the annual number of live births was observed to be a factor significantly associated with the closure of obstetrics departments (odds ratio: 0·995; confidence interval: 0.993-0.997). Areas in which driving times to the next hospital site with an obstetrics department exceeded the 30 and 40 min threshold increased from 2014 to 2019. Scenarios in which only hospital sites with a pediatrics department or hospital sites with an annual birth volume of ≥ 600 were considered resulted in large areas in which the driving times would exceed the 30 and 40 min threshold.

Conclusions

The annual number of live births is a factor significantly associated with the closure of obstetrics departments. Despite the closure, good accessibility is maintained for most areas in Germany. Although further regionalization may ensure high-quality care and efficiency, it will have an impact on accessibility.

Key messages

• Despite the closure of many obstetric departments, regional accessibility to obstetric care remains good for most areas in Germany.

• Further regionalization may ensure high-quality care and efficiency but will have an impact on accessibility.
Childhood obesity prevention in schools and municipalities – the digital planning tool WEPI
Authors: Schröder M , Berner R , Babitsch B , Hassel H
Published: October 2022

Background

The development of theory-based prevention efforts is complex and often not feasible in the daily work of project planners. Planning tools such as the Intervention Mapping Approach (IMA), which is a gold standard for project planning, cannot be used in practice without preconditions. How can prevention planning be evidence-based but also practical? Against this background, the research project WEPI was developed, funded by the Federal Ministry of Health, Germany. WEPI is a digital planning tool based on the IMA, that guides municipalities and schools in planning childhood obesity prevention efforts.

Methods

From April 2019 to October 2020, the planning tool was developed. In October 2020 and February 2021, WEPI was tested for the first time by selected municipalities (n = 4) in Bavaria and schools (n = 4) in Lower Saxony. Based on this, the modified planning tool was tested for a second time throughout Germany (05-11/2021). Handling and acceptance were evaluated in a questionnaire survey.

Results

The first test showed that content and technical aspects needed to be optimised in order to bring scientific demands and practical feasibility together. Six municipalities and eight educational institutions participated in the second test phase. The respondents (n = 14) indicated that WEPI facilitates structured project planning (86%) and supports collaboration with colleagues (64%). 93% would use the planning tool again. WEPI offers evidence-based methods for practical implementation as well as a download area, including a template for a project application or a project summary. This service was also evaluated as very helpful (64%).

Conclusions

Through step-by-step guidance, WEPI facilitates evidence-based project planning and ensures planning quality. Effort and benefit are in good proportion. Further optimisations are needed to improve the user-friendliness.

Key messages

• WEPI provides a comprehensive roadmap, helping practitioners to approach a structured project planning.

• Practitioners’ participation promotes acceptance and provides a user-friendly development.
Parental Perception of childhood obesity
Authors: Van Wyk A
Published: October 2022

Background and aims

Childhood obesity rate continues to grow in the UK with children from deprived backgrounds being at greater risk. While a large part of the literature focuses on the determinants of child obesity less is known about the factors that can lead a parent to misclassify their child’s weight status. The aim of this study was to investigate parental perception of their child’s weight status, compared to their measured weight.

Methods

Height, weight, and waist circumference were measured for 232 school children enrolled in Year 2 and Year 5 during the academic year 2019-2020 from ten schools in Barnet Council, London, UK. In addition, data were collected from parents on their child’s weight status and perception, health beliefs, eating habits, exercise habits, family anthropometric and health information. Information from 110 mothers and 17 fathers was retrieved. The WHO growth charts were used to classify the children’s BAZ scores.

Results

Results show that 46% of the parents classified their child’s weight status incorrectly, they either overestimated or underestimated their child’s body weight and/or shape. Specifically, 52% of parents of overweight/obese children reported their children as normal weight. Factors associated with parents’ child weight status misclassification child’s age (p = .771), ethnicity (p = .445), parents’ education (p = .227), and marital status (p = 0.07).

Conclusions

Parental perception of child’s weight status has important implications in terms of changes in household eating behaviours and attitudes. Understanding the key factors affecting parental perception is of paramount importance when developing interventions and policies aimed at tackling child obesity.

Key messages

• Parents classify their children’s weight status incorrectly, making it hard for policy change to be effective.

• Policy change can only happen if parents play an active role in understanding and perceiving if their child is overweight or obese.
Self-reported physical and emotional health among left behind children in Lithuania. A pilot study
Authors: Racaite J , Antia K , Winkler V , Dambrauskaite E , Tracevskyte I , Lesinskiene S , Surkiene G
Published: October 2022

Background

Left behind children (LBC) are children living with caregivers, while their parents work abroad. In recent decades Lithuania had lost ¼ of its population due to emigration, but the prevalence of LBC and their health needs are not sufficiently studied. The aim of study was to evaluate the association between self-reported health, emotional and behavioural difficulties between LBC and non-LBC.

Methods

The cross-sectional study was approved by the Biomedical Research Ethics Committee, No. 2021/11-1378-861. In March 2022, this pilot study collected data from adolescents aged 12-17 years at three randomly selected schools from the migration affected regions. Parents and children provided informed consent to participate in pilot study. Self-reported measures collected from the participants: Strengths, and Difficulties Questionnaire (Goodman, 2005) and a questionnaire on demographics and on the health situation. Chi2 tests and logistic regression were calculated by using Stata (version 15.1).

Results

The sample consisted of 127 children (mean age 15.2, SD 1.27; 54 boys, 72 girls) including 39 LBC. Mostly fathers left to work abroad (n = 36), but majority of children (n = 36) regularly communicated remotely with their migrated parents. Binary logistic regression results show that LBC children tend to evaluate their health as ‘poor, ‘bad', or ‘very bad’ (OR 2,33; 95CI [1,02-5,33]). There were no differences for emotional and behavioural problems. Preliminary results from multiple regression model showed that children with self-reported emotional/behavioural difficulties (OR 3,06; 95CI [1,12-7,84]), females (OR 4,99;95CI [1,55-16,13]) and LBC (OR 2,44; 95CI 0,95-6,25]) more likely evaluate their health as ‘poor', ‘bad’ or ‘very bad’ (likelihood-ratio test=23,72; model p < 0.001).

Conclusions

This pilot study found negative association between parental migration and children’s self-reported health. However, a more comprehensive study with a larger sample size is needed.

Key messages

• Pilot study suggests negative association between parents migration and children’s self-reported health.

• More comprehensive study in bigger sample for the emotional/behavioural/communication difficulties between left behind children needs to be done.
Performance evaluation drives organizational change: a case-study from Tuscan Teaching Hospitals
Authors: Ferrari A , Bonciani M , Vainieri M
Published: October 2022

The 1985 WHO recommendation on caesarean-section (CS) stated that CS rates over 10-15% might be clinically unnecessary. The Performance Evaluation System of Sant'Anna School of Advanced Studies systematically monitors the regional health performance of Tuscany, ITALY. CS rates in Pisa Teaching Hospital (TH) were the highest in Tuscany before 2018 (almost 30%), but then started to decrease, reaching the lowest values in Tuscany, around the WHO threshold (15%). We aimed to assess and demonstrate such performance improvement in Pisa TH, taking the other two THs of Tuscany as comparators. Our outcomes were NTSV CS rates (nulliparous, term pregnancy, singleton, vertex), total CS rates, Robson Class 1 CS rates, NTSV episiotomy rates, and operative delivery rates, computed annually from 2016 to 2020 in the three THs of Tuscany. We obtained data from regional administrative databases. We performed difference-in-differences to compare the average change from the pre- (2016-2017) to the post-period (2018-2020) in the outcomes between Pisa TH and the other two THs, assuming that Pisa TH implemented organizational changes at the end of 2017 to improve the hospital performance on CS. Comparing Pisa TH with the other two THs, we found a significant pre-to-post reduction in NTSV CS rates (p < 0.001), total CS rates (p = 0.016), Robson Class 1 CS rates (p = 0.039), and episiotomy rates (p = 0.059), while no significant change emerged for operative deliveries. As a result, after 2017, Pisa TH reached significantly lower NTSV CS rates (p < 0.001) and Robson Class 1 CS rates (p = 0.027) and non-significantly higher total CS rates and episiotomy rates compared to the other two THs. This case study proved beyond a mere descriptive assessment that a statistically significant performance improvement in CS and episiotomy rates occurred in Pisa TH after 2017 following organizational changes. Comparison with the pre-period trend and the other two THs of Tuscany made these findings robust and reliable.

Key messages

• The Performance Evaluation System allowed to benchmark the performance of Tuscan THs, revealing the worst practice of Pisa TH on CS, and fostering organizational changes to be explored qualitatively.

• Such organizational changes improved hospital performance on CS rates and on the maternity pathway in general, eventually making Pisa TH the best performer on CS in Tuscany.
Support perceived by foreign-origin women in Finnish maternity care: a comparison of two surveys
Authors: Schmidt A , Chen A , Klemetti R
Published: October 2022

Background

Evidence suggests that foreign-origin women are at risk of poorer pregnancy outcomes, both worldwide and in Finland. This study examined if foreign-origin women felt adequately supported by healthcare providers during their perinatal care in Finland.

Methods

Foreign-origin women who gave birth in Finland within the last 3 years were recruited via snowball method as part of the MOM Survey (MS). Data were also extracted from birthing parents’ responses to the 2020 national FinChildren Survey (FC), which consisted of data from parents in Finland with 3-6-month-old babies. Only responses submitted to MS from women born outside of Finland (n = 291) and responses submitted to FC by women born in Finland (n = 7984) were analyzed. Reported levels of adequate support from each group were compared using an independent sample proportion t-test. Data were then pooled and analyzed via binomial logistic regression.

Results

MS respondents were older, more highly educated, and reported a higher proportion of single parenthood. 70.9% of MS respondents reported receiving adequate support regarding general well-being during pregnancy, compared to 90.2% of FC respondents (p < 0.001). Statistically significant differences (p < 0.001) were also seen in levels of support for parenthood (MS 74.3%, FC 92.8%), depression (MS 68.1%, FC 94.7%), fear of childbirth (MS 81.5%, FC 91.7%), and preparing for childbirth (MS 65.0%, FC 80.6%). After adjusting for age, education, and relationship status, FC mothers were still 4 to 9 times more likely to report receiving adequate support in these areas as compared to their MS counterparts.

Conclusions

Women born outside of Finland were significantly more likely to report receiving inadequate support in multiple aspects of their perinatal care when compared to Finnish-born women. This held true even after adjusting for demographic differences. More research is needed to better understand this phenomenon and to ensure equitable care in the future.

Key messages

• Minority populations continue to grow in Finland, a country often seen as a global leader in maternal care. Supporting these populations is imperative to ensure quality maternal healthcare for all.

• Our observation that foreign-origin women felt less supported during pregnancy suggests that new care models or strategies may be needed to address their unique needs in peripartum care.
Parents’ perceptions of barriers & facilitators for adhering to advice from community health nurses
Authors: Carlsson RR , Brautsch LAS , Kierkegaard L , Bonnesen CT
Published: October 2022

Background

Childhood obesity is a global health problem and infancy is an important window of opportunity for promoting healthy weight development. In Denmark, community health nurses cover most families with a new-born child leaving a huge potential for promoting healthy weight development. This study examines parents’ perceptions of barriers and facilitators for adhering to advice from the health nurse regarding healthy weight development of their child.

Methods

Sixteen interviews with parents (children aged 0- 2 years) living in Denmark were conducted. Parents were strategically sampled representing variations across child age, family socioeconomic position, ethnicity, and geography. All interviews were based on a semi-structured interview guide, recorded, and transcribed verbatim and analysed using a thematic analysis.

Findings

Parents generally experience visits from their health nurse positively. Health nurses are emphasized as a confident and trustful relation and the key informant about children's’ health. Variations in how parents adhere to advice favouring healthy weight development of their child were found. Generally, parents adopted a positive attitude towards the health nurse, also when she addressed behaviour or practice of the parents, but parents expressed the importance of doing so in a non-stigmatising or finger pointing manner. The degree to which parents follow the advice from their health nurse depend on cultural background, advice from family and friends, and use of online information.

Conclusions

Parents generally have a confident and trustful relation to the health nurse, and she constitutes the key informant on child health. This leaves a potential for the structure of Danish health nurses for future interventions promoting healthy weight development. Adaptation of the future intervention program to the needs of parents will increase the chances of developing a relevant, successful, and sustainable intervention.

Key messages

• Health nurses are emphasized as a trustful relation and the key informant about children’s’ health, but parents expressed the importance of addressing behaviours in a non-stigmatising manner.

• Adapting information gained from parents in development of the trial will increase the chances of a relevant, successful, and sustainable intervention promoting healthy child weight development.
Empowering pregnant women to improve diet quality: a RCT among pregnant women in the Netherlands
Authors: van Lonkhuijzen RM , Wagemakers A , de Vries JHM
Published: October 2022

Objective

A healthy diet during pregnancy is crucial for the health of both mother and child, but pregnant women often do not meet the nutritional requirements. Empowering pregnant women to improve their diet quality could play a significant role in improving maternal nutrition and health. However, empowerment has been rarely used in nutritional interventions. Based on research and input from stakeholders, we developed Power 4 a Healthy Pregnancy (P4HP). P4HP consists of four additional consults by the midwife or dietician to discuss nutrition with the pregnant women from an empowerment perspective. This study aims to evaluate the effectiveness of P4HP on diet quality, empowerment, and health of pregnant women.

Methods

A cluster randomized controlled trial started in January 2022 in 14 Dutch midwifery practices, with a total of 175 pregnant women in both the control and intervention groups (N = 350). Women in the intervention group follow P4HP in addition to their usual birth care. Measurements are carried out at the beginning and end of pregnancy. Diet quality is measured using the Dutch Healthy Diet index 2015, specifically adapted for pregnancy. Empowerment is assessed using the Pregnancy-Related Empowerment Scale, Sense of Coherence (SOC) using the SOC-3 scale, Self-Rated Health using a General Self-Rated Health question, and Quality of Life using a Visual Analogue Scale. Results will be analyzed using Linear Mixed Models to analyze the treatment effect of clustered data.

Results

Baseline results of 100 pregnant women indicate that they do not meet the Dutch dietary guidelines. We hypothesize that P4HP will lead to improvements in diet quality, empowerment, and health among the intervention group compared to the control group.

Conclusions

Our findings will show the effect of P4HP on pregnant women’s diet quality, empowerment, and health. We expect to present our preliminary results during the congress.

Key messages

• Our findings will show the effect of four additional nutritional consultations from an empowerment perspective on pregnant women’s diet quality, empowerment and health.

• Empowering pregnant women to improve their diet quality could play a significant role in improving maternal nutrition and health.
Germany vs. Austria: country-specific differences in becoming parents during the COVID-19 pandemic
Authors: Preiß J , Florea C , Angerer M , Schabus M
Published: October 2022

Background

Becoming parents can be a big challenge, but how is this experience affected by the COVID-19 pandemic and its measures?

Methods

Between 18.05.2021 and 01.07.2021, we conducted an online-survey to gain insight into becoming parents during the COVID-19 pandemic in Germany and Austria. The sample mentioned in this report consists of biological mothers living in Austria (n = 952) and Germany (n = 1012) who gave birth between the 16th of March 2020 (the beginning of the first lockdown in Austria) and the time of completion of the study. The mothers’ current stress levels were assessed with the Perceived Stress Scale (PSS), and postnatal depression symptoms were quantified with the Edinburgh Postnatal Depression Scale (EPDS). Furthermore, we included questions to measure perceived social support and pandemic-related stress.

Results

Current stress levels (U = 555677.50, z = 5.90, p < .001) and postnatal depression symptoms (U = 546354.00, z = 5.15, p < .001) were significantly higher in the German sample as compared to the Austrian sample. Yet, Austrian mothers reported higher social support as compared to the German mothers (U = 387834.00, z = -7.48, p < .001). Furthermore, we found higher levels of perceived social support to be associated with lower current stress levels (rs = -.40, p < .001). On average, perceived stress was moderately high in both samples (MGermany = 18.58, SDGermany = 6.60; MAustria = 16.76, SDAustria = 6.57).

Conclusions

Stress levels and depression symptoms seem to be high and prevalent due to the pandemic and it is highly indicated to take action such as supporting families in need and emphasising social support in order to reduce mental health problems of parents as well as their children in the aftermath of the pandemic.

Key messages

• Findings underpin the protective role of social support against psychological distress in new parents and show the high strain at current.

• Action needs to be taken in order to support parents and children at risk.
Evaluation of an integrated physical activity program for pregnant women: WELL-DONE! Study
Authors: Marini S , Masini A , Caravita I , Zannoner A , Scognamiglio F , Coa AA , Rescigno I , Sicari G , Castagna G , Dallolio L
Published: October 2022

Background

Regular practice of physical activity (PA) during pregnancy has benefits for maternal and fetal health. Therefore, pregnant women (PW) should practice at least 150 minutes of moderate PA per week following the WHO guidelines. The aim of the study is to evaluate the effect of an adapted physical activity (APA) intervention for PW, to be included in childbirth preparation classes (CPCs) in terms of levels of PA, quality of life, physical performance, self-efficacy, sleep quality and anxious-depressive states.

Methods

The WELL-DONE! Study is a quasi-experimental study conducted with pregnant women at St. Orsola hospital, Bologna. We compared an experimental group (EG) with a control group (CG). EG attended 1hour/week session of APA during the usual CPCs for a 6 weeks period, while the CG received a one hour lesson about PA recommendation in pregnancy. The pre-post evaluation was carried out through questionnaires and motor tests, to which PW were subjected at baseline (T0), after the intervention (T1) and 3 months after delivery (T2). We used the Pregnancy Physical Activity Questionnaire (PPAQ) to collect data regarding PA levels and sedentary behavior.

Results

A sample of 50 pregnant women aged between 29-46 (mean age=35.44±3.99) was involved in the study (39 CG, 11 EG). After the intervention, PPAQ sedentary activity score was reduced in the EG group (-10.20±24.12) while remaining similar in the CG (0.58±22.65) without statistically significant differences between groups.

Conclusions

Preliminary results of the study show a reduced sedentary time in PW, highlighting a positive trend in the EG. This data underlines that incorporating APA in the CPCs can be an effective and safe strategy. Nevertheless, further analysis must be needed to find out if this trend can be observed in light PA, in the moderate and vigorous one.

Key messages

• Physical activity during pregnancy is a valuable tool for improving both mother and child well-being.

• Physical activity interventions, implemented in CPCs, seem useful in order to raise awareness about PA importance and reduce sedentarism in PW.
Potential association between working memory and physical fitness status: the BRAVE study
Authors: Masini A , Sanmarchi F , Ricci M , Longo G , De Gioia ER , Zannoner A , Tessari A , Ceciliani A , Dallolio L
Published: October 2022

Introduction

The World Health Organization launched a global action plan targeted to obtain a 15% relative reduction in the global prevalence of physical inactivity in adolescents by 2030 also promoting school-based PA interventions and programs in school. Active Breaks (ABs) are a school-based intervention consisting of short bursts (5-15 minutes) of Pa led by teachers or peer. Many researches investigated the implementation of ABs into primary school setting as a strategy to reduce sedentary behaviour, improve cognitive and physical function. However, this kind of intervention has not extended to secondary school, especially in Italian context. For this reason we started the BRAVE study to evaluate the potential effect of implementing ABs in secondary school. The study is currently in the administration phase of ABs to adolescents The preliminary analysis aims to underline a potential association between working memory performance (WM) and physical fitness status among secondary school students at baseline.

Methods

In March 2022 we conducted baseline assessment in a secondary school in Valsamoggia (Bologna, Italy). Working memory was evaluated using backward digit span while physical fitness status was assessed using three different fitness test: standing long-jump (SLJ), six minute Cooper Test (6MCT) and Shuttle run test (SR).

Results

A total of n = 125 adolescent, mean age 12.79±0.89, were enrolled in the study. After performing a regression analysis we found that WM is significantly associated only with age of student (b = 0.2, 95%CI 0.25, 0.11 p = 0.02). A trend also emerged between WM performance and SLJ but with no statistically significant differences (b = 0.160, 95%CI 0.03, 0.02, p = 0.09). The 6MCT and HT have no relevant associations with WM score.

Conclusions

These preliminary results suggest that age is associated with cognitive performance but no positive association were found between WM score and physical fitness status excepted for a small trend with SLJ test.

Key messages

• Age is related to WM in adolescent students.

• ABs interventions could represent a valid strategy to encourage movement, improve cognitive and physical fitness performance.
Invisible mother-daughter heredity
Authors: Capitani E , Lorenzini C , Baragatti E , Alaimo L , Messina G , Nante N
Published: October 2022

Background

The type of maternal caregiving impacts children’s growth and can lead to heritable changes in gene expression. When women become mothers, they adopt parents’ behaviours similar to those received in the family of origin. The study investigates if a birth’s social and cultural content can be seen as heredity transmitted from mother to daughter.

Materials and methods

A retrospective study was conducted on a group of mothers recruited across Italy through the social network Facebook. The study was carried out using a questionnaire administered from July to September 2021. The survey consisted of 21 questions. The analysis was carried out using STATA 14.

Results

Our sample consisted of 6051 mothers; the mean age was 37.7 years. Womens born by spontaneous birth has 2.1 times higher risk of having a spontaneous birth for their first child. Those born by operative labour have 2.7 times higher risk of having an operative delivery for their first child. Finally, those born by caesarean section are 2.3 times more likely to have a caesarean section for their first child. On the other hand, those born by preterm labour have 1.8 times higher risk of delivering their first child preterm. Those who were breastfed have 2 times higher risk of breastfeeding their first child. Women who have been told their birth is an extraordinary event are 2 times more likely to consider the birth of their first child as a problematic but still extraordinary event. Those who received a description of childbirth from their mother as a problematic event are twice as likely to consider the birth of their first child as a traumatic event overall.

Conclusions

The results show that transmission, written in the psyche, in preverbal and in internalisations derived from the relationship with one’s mother, is true and strongly present. Also, the ways of one’s own birth are so strong as to have repercussions on the daughter’s own and subsequently also on her children.

Key messages

• The unconscious objects, which are projected onto the children, can also take the form of both physical and psychic somatisations, which are repeated cyclically between generations.

• The way in which birth is cared for and the quality of care provided at this unique time in a woman’s life will leave an imprint not only on the woman herself, but also on future generations.
Enablers and barriers to effective parenting within the first 1000 days of life
Authors: Adebiyi B , Goldschmidt T , Benjamin F , Sonn I , Rich E , Roman N
Published: October 2022

Background

The first 1000 days is the period between conception and a child’s second birthday. Globally, research on parenting is in an advanced stage, but parenting research focusing specifically on parenting in this developmental phase is limited in South Africa. Therefore, this study explores the enablers and barriers to effective parenting within the first 1000 days through the lens of parents and caregivers in low socio-economic communities.

Methods

This study was conducted in low socio-economic communities of South Africa. An exploratory qualitative research design explored the enablers and barriers to effective parenting within the first 1000 days of life. Thirty participants were purposively selected and interviewed in this study. A semi-structured interview schedule was used for all interviews. The data were analysed using inductive thematic analysis.

Results

Two main categories emerged (effective parenting enablers and effective parenting barriers) during the data analysis. The main enablers of effective parenting within the first 1000 days of life include a support system, healthy behaviours/environment, job opportunities, religion, information/knowledge, and professional assistance. On the other hand, the main barriers to effective parenting were low socio-economic circumstances, environmental circumstances, lack of partner’s support, the negative impact of technology, and lack of access to services.

Conclusions

Enablers that need to be promoted for effective parenting range from support systems to professional assistance for parents. Also, barriers that need to be removed for effective parenting range from low socio-economic circumstances to a lack of partner’s support for parents. This is because effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. Therefore, there is a need to develop policies and interventions to promote effective parenting within the first 1000 days in the communities.

Key messages

• Effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life.

• There is a need to develop policies and interventions to promote effective parenting within the first 1000 days in low socio-economic communities.