bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type of delivery, birthweight, breastfeeding and overweight: the 2019 Italian results
Authors: Nardone P , Ciardullo S , Spinelli A , Buoncristiano M , Andreozzi S , Bucciarelli M , Salvatore M A , Galeone D ,   The OKkio alla SALUTE Group 2019
Published: October 2023

Abstract

Introduction
According to recent studies, childhood obesity can be affected by type of delivery, birthweight and breastfeeding. The data from the surveillance system OKkio alla SALUTE, coordinated by the Italian National Institute of Health, have been used to investigate this association. OKkio alla SALUTE, promoted by the Italian Ministry of Health, is part of the WHO European Childhood Obesity Surveillance Initiative.

Methods
The study population are children aged 8 or 9 years in the third grade of all primary schools. A stratified cluster sample design, with class as the sampling unit, was used. Children were weighed and measured by trained local health staff and were classified as overweight or obese using the age and sex-specific International Obesity Task Force cut-offs. Parents of children completed a brief questionnaire to assess risk behavior, including information about the birth and the first few months of life of their child.

Results
In 2019, the sixth round of data collection involved 47,219 children and 50,370 parents with a response rate higher than 94%. 20.4% (95% CI 19.9-20.9) of 8-9 years old children were overweight and 9.4% (95% CI 9.0-9.7) were obese. The prevalence of obesity has decreased steadily since 2008 to 2019. The prevalence of overweight and obesity was higher for children born by caesarean section (33% vs 27% by vaginal childbirth), increased with birthweight (for birthweight &gt;4,000 kg: 39.4% vs for birthweight&lt;2,500 kg: 25.1%) and among children who had been breastfed never or less than 1 month (33.6% vs breastfeeding 6 months and above: 28.9%). Logistic regression analysis confirms the association between characteristics at birth/breastfeeding and overweight/ obesity.

Conclusions
Type of delivery, birth weight and breastfeeding seem to play a role in the prevalence of childhood overweight and obesity. Although these results may be affected by recall bias, this is unlikely to materially affect the results.

Key messages
• Type of delivery, birth weight and breastfeeding seem to play a role in the prevalence of childhood overweight and obesity.
• Information on breastfeeding and other characteristics at birth that might be associated with overweight and obesity is essential for tracking progress in countries.
Ramadan during pregnancy and offspring health over the life course: A systematic review
Authors: Van Ewijk R , Pradella F 
Published: October 2023

Abstract

Background
The Muslim population in Europe is increasing, with by now more than 5% of the population being Muslim. During pregnancy, many Muslim women choose to adhere to the Ramadan fast. Research on health effects of Ramadan during pregnancy on the offspring has been conducted through two separate literature strands. One compares offspring of women who chose vs didn't choose to fast and focuses on birth outcomes. The other strand uses an ITT-approach, classifying Muslims as potentially vs certainly not exposed based on their birthdates relative to Ramadan. The ITT-studies’ design allows to also study later-life health. This review combines both strands and evaluates their ability to identify causal effects between Ramadan during pregnancy and offspring health.

Methods
A systematic literature search using PubMed, EconLit and Web of Science plus a Google Scholar search yielded 35 eligible studies. Data were extracted and quality assessed using a checklist.

Results
Non-ITT studies often struggle to adequately address bias from self-selection in treatment, with a high risk of confounding and unknown direction of bias. ITT studies, while producing results biased toward zero, are likely to reveal causality and relied on large datasets, leading to high statistical power. Studies meeting the quality threshold find limited evidence of effects on birth outcomes, such as birthweight, but show increased child mortality rates and worse adult health outcomes along several dimensions. These effects tend to increase in magnitude with age, which is congruent with fetal programming theory.

Conclusions
Medical advisories, guidelines and previous literature reviews mostly focused on non-ITT studies that primarily examined birth outcomes. However, health effects mostly show up at later ages. Consequently, adverse long-run effects are often overlooked, and pregnant Muslims remain not fully informed of potential health impacts on their offspring of their Ramadan fasting decisions.

Key messages
• Many pregnant Muslims decide to fast during Ramadan. Rigorous quality checking of the research on offspring health effects is needed to provide informative evidence for the growing Muslim population.
• Adverse health effects of Ramadan during pregnancy mostly become visible only years after birth. Medical advisories tend to focus on evidence on birth effects, overlooking long-term adverse effects.
Gaps, demands and fragmentation – exploring the marketisation of Finnish maternity care
Authors: Jones M 
Published: October 2023

Abstract

Background
Public maternity services are considered a source of pride in Finland. They comprise of publicly funded community-based clinics that are free at the point of delivery. The services play an important role in the care of the pregnant parent and the monitoring of foetal growth and development. However, maternity services have not been immune to the strains faced by public services, such as funding cuts and staff shortages. Over recent years, an increasing number of private providers have begun to offer maternity care. These include large healthcare companies and small midwife-led services. The aim of this study is to better understand various developments fuelling the maternity service market in a country that offers free maternity care. This study provides new insights from the perspective of professionals providing private services. I ask: what needs are private providers attempting to respond to and how? Additionally, I explore the role of private services in creating new demands and how the expanding market may contribute to the fragmentation of maternity care.

Methods
The materials consist of individual interviews with health professionals (n = 20) conducted during the spring of 2023 and analysed using thematic analysis.

Results and conclusions
Preliminary findings suggest that private providers are attempting to respond to needs that are currently neglected by the public sector. These include a gaps in specialist care, emotional care and care quality. Hence, those with disposable income are able to purchase services and products that are not available in the public sector. The existence of this market also contributes to the growing demand for laboratory tests, screening and ultrasounds without medical indication. Expectant parents use private and public services in various combinations, but a lack of formal collaboration between different service providers can lead to fragmented care if health information is not shared between professionals.

Key messages
• Finnish maternity services are expanding and diversifying as increasing number of private providers begin to offer pregnancy care.
• Private services attempt to respond to expectant parents’ wishes. However, market expansion can also contribute to the increased demand for screening and the fragmentation of care.
Syrian Women Knowledge and Attitudes Towards Hepatitis B Prevention
Authors: Bohsas H , Alibrahim H , Swed S , Nour Nasif M , Hossam El Din Moawad M , Albakri K , Badr Almoshantaf M , Kazan L , Hafez W , Bakkour A 
Published: October 2023

Abstract

Background
Globally, mother-to-child transmission during childbirth is the most prevalent transmission method of hepatitis B (HBV). However, early immunization following birth is a safe and effective method of preventing this disease. This study evaluates Syrian mothers’ and pregnant females’ knowledge, attitude, and practice regarding HBV prevention and immunization.

Methods
This online cross-sectional study was performed in Syria between 2 October and 12 November. The inclusion criteria for this study were Syrian pregnant women who visited obstetrics and gynaecologist clinics for prenatal care, delivery, and postpartum checkups. The survey was adapted from a previous study, which contains 33 items divided into three sections. Data were analyzed using descriptive and multivariate logistic regression.

Results
This study enrolled 419 participants with a mean age of (28.4±5.9). More than half of the participants agreed that HBV could be transmitted from mother to her child at birth, and about two-thirds of them agreed that HBV vaccination is necessary for their infant (87.4%). Among participants with a university education degree, 35.7% revealed good knowledge, while only 12.3% of respondents with a primary school education level have good knowledge. More than half of housewife participants have shown positive attitudes (52.4%). Females with academic careers have a higher probability of good knowledge and positive attitudes than housewife women (OR = 107.09, P value&lt;0.05) and (OR = 16.31, P value&lt;0.05), respectively.

Conclusions
Syrian women have a moderate knowledge level about HBV prevention, with gaps in knowledge and attitudes among low-educated women. Performing local awareness campaigns about HBV and its vaccination for women can increase their knowledge and attitudes about this topic. Obstetric care providers should provide more information for pregnant females about HBV prevention for their children which may limit the occurrence of this phenomenon.

Key messages
• Syrian women have moderate knowledge of HBV prevention for their children, while lower-educated women have gaps in knowledge and attitudes.
• Local awareness campaigns about HBV and its vaccination for women can improve their knowledge and attitudes.
Associations of famine exposure in early life with height in two consecutive generations in China
Authors: Yao W Y , Yu Y F , Li L , Xu W H 
Published: October 2023

Abstract

Background
Poor nutrition early in life is associated with short stature, which is known to be associated with increased risk of cardiovascular disease and mortality in later life. Less evidence is available about whether early life nutrition affects height growth in the subsequent generation.

Objective
We aimed to investigate associations of famine exposure in utero and early-childhood with height across two generations.

Methods
We used the China Health and Nutrition Survey data and included 5,401 participants (F1) born in 1955-66 (the calendar year around the Chinese Great Famine in1959-61) and their 3,930 biological offspring (F2). We classified F1 participants into subgroups by famine exposure status (unexposed/exposed) and timing (fetal-/childhood-exposed) according to their birth year, and grouped F2 by their parents’ exposure. Linear regression models were conducted to evaluate the associations of famine exposure with adult height of F1 and F2. Linear mixed effect models with fractional polynomial functions were performed to estimate the difference in height between exposure groups of F2 during childhood.

Results
Participants (F1) exposed to famine in utero or childhood were shorter than those unexposed by 0.41 cm (95% CI: 0.03, 0.80) and 1.12 cm (0.75, 1.48), respectively. Offspring (F2) of exposed fathers were also shorter than those of unexposed parents by 1.07 cm (0.28, 1.86) during childhood (&lt;18 years) and by 1.25 cm (0.07, 2.43) in adulthood (≥18 years), and those with exposed parents had a reduced height during childhood by 1.29 cm (0.68, 1.89). The associations were more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring (all p for interaction &lt; 0.05).

Conclusions
The findings support the intergenerational effect of famine exposure in early life on height in Chinese populations, and indicate public health significance to improve nutritional status of mothers and children in the long run.

Key messages
• Exposure to famine in uteri or early-childhood were associated with a shorter height during adulthood and in their offspring.
• The adverse impact of famine exposure was more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring.
The role of parental composition in improved birth outcomes during the COVID-19 pandemic in Finland
Authors: Oberndorfer M , Luukkonen J , Remes H , Martikainen P 
Published: October 2023

Abstract

Background
In some high-income contexts, the COVID-19 pandemic was associated with improved birth outcomes, which was hypothesised to be caused by a positive effect of the pandemic on maternal health. Conversely, an improvement in birth outcomes may have been driven by pandemic-induced compositional changes in parental characteristics, which are associated with health outcomes at birth. Research on this consequence of the COVID-19 pandemic is critical for understanding pandemic-induced changes in population health (inequalities) and planning of public service provision.

Methods
We analysed population-wide data on birth outcomes and parental sociodemographic characteristics from Finland collected between January 2015 and December 2021 (n = 336,000). The total effect of pandemic-induced compositional changes on birth weight and preterm birth rate was estimated by segmented regression models using three conception cohorts: a) conceived prior to May 2019, b) conceived between June 2019 and February 2020 (to account for in-utero exposure to the pandemic), and c) conceived during the pandemic between March 2020 and February 2021 (to prevent selection bias).

Preliminary Results
Adjusting for secular trends and seasonality, and accounting for in-utero exposure to the pandemic, the estimated effect of parental compositional change on average birth weight was 36.5 grams [95%CI: 24.8; 48.3]. Correspondingly, this compositional change was associated with a 16.2% [95%CI: 8.8%; 23%] lower risk of preterm birth for babies conceived during the pandemic.

Conclusions
Pandemic-induced changes in parental composition drove the modest increase in birth weight and substantial reduction in preterm births for babies conceived during the pandemic. Should the postponed pregnancies among population groups at risk for worse birth outcomes eventually realise post-COVID-19, health care and educational systems may need to prepare for cohort-specific variations in service demand.

Key messages
• Improvement in birth weight and preterm birth rate among babies conceived during the COVID-19 pandemic were driven by pandemic-induced changes in parental composition.
• Further research using natural experimental designs on this compositional change and health outcomes can inform future public service provision.
Congenital malformations registered in the Federation of Bosnia and Herzegovina 2019-2021
Authors: Cilović-Lagarija Š , Skočibušić S 
Published: October 2023

Abstract

Congenital malformations are defined as structural or functional anomalies that occur in utero or at birth and can be detected at an early age. They are also known as birth defects, disabilities or congenital malformations. Congenital malformations are accompanied by hereditary or developmental disabilities or disease. From the establishment of the registry in early 2019 until the end of 2021, the total number of reported congenital malformations is 449. According to available data from EUROCAT (European network of population-based registries for the epidemiological surveillance of congenital anomalies), the average rate of congenital malformations in the countries of the European Union (EU) is 262/per 10,000 live births, while the registered rate of congenital malformations in the Federation of Bosnia and Herzegovina is 261/per 10,000 live births. In the Federation of Bosnia and Herzegovina, the highest incidence rate was registered in Sarajevo Canton (175 cases with a rate of 416/10,000 live births) and Tuzla Canton (122 cases with a rate of 356/10,000 live births). The most common congenital malformations are heart defects, cleft lip and palate, musculoskeletal deformities and Down syndrome. In the Federation of Bosnia and Herzegovina (FBiH) in 2020, 135 children under the age of 5 died, among which 18 children (13.3%) died from congenital malformations, deformations and chromosomal abnormalities (Q00-Q99). Congenital malformations can lead to chronic diseases and disabilities, death of infants and children up to five years of age. Congenital malformations represent a significant public health problem, given that they lead to disability, incapacity and pressure on the health system, as well as the problem of social integration of patients.

Key messages
• The registered rate of congenital malformations in the Federation of Bosnia and Herzegovina is 261/per 10,000 live births.
• Congenital malformations can lead to chronic diseases and disabilities, death of infants and children up to five years of age.
Vaccination choices among pregnant women: findings from the MAMI-MED cohort
Authors: Magnano San Lio R , Barchitta M , Maugeri A , La Rosa M C , La Mastra C , Favara G , Ferrante G , Galvani F , Ettore G , Agodi A 
Published: October 2023

Abstract

Background
According to the Italian National Immunization Plan 2023-2025, vaccinations against Measles, Mumps, Rubella (MMR), Varicella and Human Papillomavirus (HPV) are indicated for women of childbearing age. During pregnancy, vaccination against Diphtheria, Tetanus, and Pertussis (DTaP), and Seasonal Influenza are recommended. The present analysis aimed to estimate vaccination choice and its main determinants among pregnant women.

Methods
We used data from the “MAMI-MED” cohort, an ongoing prospective study on mother-child dyads established in December 2020. Socio-demographic information (i.e., age, educational level and employment) were assessed at enrollment, during the first trimester visit at the Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima (Catania, Italy). Self-reported maternal vaccination status was collected at delivery.

Results
Among 1004 women with a complete vaccination assessment, 83.5% were vaccinated against MMR, 87.4% against DTaP, 68.3% against Varicella, while only 23.7% and 9.4% against HPV and Seasonal Influenza, respectively. During pregnancy, only 8.7% and 21.1% of women were vaccinated against DTaP and Seasonal Influenza, respectively. The lack of information was the main ground for refusal, accounting for 93.7% for HPV, 82.5% for Influenza, 64.7% for DTaP, 31.8% for MPR, and 18.9% for Varicella. Women vaccinated against HPV and MMR were younger than their unvaccinated counterpart (p &lt; 0.001 and p = 0.023, respectively). The logistic regression showed that the odds of being vaccinated against HPV increased with increasing age, adjusting for education and employment (OR = 1.12; 95% CI = 1.09-1.16; p &lt; 0.001).

Conclusions
The analysis showed modest vaccination coverages, mainly depending on the lack of information about vaccination programs. Moreover, we observed that younger women were more aware of HPV vaccination, which probably reflects improvements in the national vaccination program over the years.

Key messages
• It is necessary to increase knowledge about vaccination among women in the reproductive age.
• Social determinants should be assessed to understand the barriers that might affect vaccination choice.
Factors influencing maternal control in child feeding in Hungary
Authors: Paulik E , Szabó A , Umami A , Molnár R , Erdős C , Maróti-Nagy Á 
Published: October 2023

Abstract

Background
Globally, more than 340 million children and adolescents aged 5-19 were overweight or obese in 2016. Obesity in children and poor dietary habits in adulthood are associated with parental feeding practices. This study aimed to characterize the sociodemographic status, lifestyle, and health related factors of mothers associated with child feeding control practices.

Methods
A questionnaire-based cross-sectional study was carried out in Hungary among 8-13-year-old students and their parents (N = 454). In this analysis only mothers of normal/overweight/obese children were analysed (n = 338). Questions included mothers’ characteristics and their practices in child feeding measured by the Hungarian version of the Child Feeding Questionnaire. It has two main categories: “risk factors and concerns” and “control in child feeding”; we analysed the last one with its three domains (restriction, pressure to eat and monitoring). Factors influencing mothers’ feeding control were analysed by multivariate logistic regression models.

Results
According to our classification 86.9% of mothers were “monitoring”, 20.0% “pressure to eat”, and 26.9% “restrictive”. Neither of the variables was explored in the regression model of “restrictive” mothers. Mothers of overweight children (79%) and of obese children (89%) were less likely to be “pressure to eat” mothers (p = 0.007, p = 0.036). Women with high education were 2.19 times more likely to be “monitoring” mothers (p = 0.047) than lower educated. Mothers who had hopeless feelings were 94% less likely to be “monitoring” (p = 0.016). Overweight children's mothers were 4.12 times likely to be “monitoring” mothers (p = 0.040) than mothers of normal weighted children.

Conclusions
In our analysis predicting factors of child feeding were educational level and mental health of mothers and nutritional status of children. Improved education, self-efficacy and mental status are important public health issues from the point of the promotion of healthy nutrition.

Key messages
• Parents, especially mothers can significantly influence children’s eating experiences, so the evaluation of mothers’ feeding control may be used in the formulation of obesity prevention in children.
• The mothers’ feeding strategy and their ideas about child feeding are determined by many factors which can be modified by the promotion of their education and health way of life.