Maternal Determinants of Feeding Practices among Children Under Two Years in Sleman District, Yogyakarta, Indonesia

@#Introduction: Optimum feeding practices can help children under two years old achieve a pivotal period of growth, health, behaviour and intellectual development. However, suboptimal feeding practices are still found in developing countries, and are influenced by maternal factors. We aim to investigate maternal education, employment, age, and feeding practices among children under two years old in Sleman District, Yogyakarta, Indonesia. Methods: The study was a cross-sectional design involving 388 mothers who had 0–24 months old children. The subjects were taken from the Sleman Health and Demographic Surveillance System, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada in 2019. The association between maternal determinants and feeding practice was analyzed using fisher’s exact and chi-square test. Results: 21.1% of children were started on infant formula at 0–6 months old. The first initiation of fruits, milk enriched porridge, and soft foods was mainly in 6–9 months old infants (63.1%; 46.6%; 49.0%), once (74.7%), twice (48.8%) and three times daily (46.1%), respectively. 30.9% of children had been given solid foods in >12 months old, three times daily (66.3%). There was a significant association between maternal employment to the first initiation and the daily frequency of infant formula (p<0.001 and p=0.008), maternal education to the daily frequency of fruits (p=0.020) and soft foods (p=0.013) feeding. Conclusion: Maternal education and employment are associated with feeding practices among children under two years old. Education on child feeding is recommended to increase their practice.

Determinantes biológicos de mortalidad neonatal, en una población de mujeres adolescentes y adultas de un hospital en Colombia / Biological determinants of neonatal mortality, in a population of adolescent and adult women of a hospital in Colombia

INTRODUCTION. La muerte neonatal está asociada a determinantes maternos, obstétricos, fetales, neonatales y los cuidados de la salud. OBJETIVO Establecer los determinantes asociados a mortalidad neonatal en una unidad de cuidados intensivos de Colombia. Métodos. Estudio de casos y controles anidado en una cohorte, donde se incluyeron 5567 neonatos vivos, de los cuales fallecieron 125. Con Stata 11.0® se construyeron las estadísticas descriptivas y mediante odds ratio (intervalo de confianza 95%) se establecieron las asociaciones. La regresión logística fue empleada en el análisis multivariado. Se consideró un valor de p<0,05 como significativo. RESULTADOS. La mortalidad se presentó en 2,25% de los neonatos, ocurriendo 76,80% de las muertes entre 0-7 días. Los determinantes maternos y obstétricos asociados de manera independiente a mortalidad neonatal incluyeron número de visitas en el control prenatal menor a 6, trabajo de parto prematuro espontáneo, sangrados del tercer trimestre e hipertensión arterial crónica. Entre los determinantes neonatales, la necesidad de reanimación cardiorrespiratoria, prematuridad o bajo peso al nacer, infecciones bacterianas graves, enfermedad de membrana hialina, hipertensión pulmonar, malformaciones congénitas y anomalías cromosómicas y cardiomiopatía hipertrófica, se asociaron independientemente a mortalidad neonatal. Para las complicaciones y eventos adversos hubo asociación independiente y estadísticamente significativa para infecciones asociadas a la atención en salud, hemorragia intraventricular grados III y IV de Papille y hemorragia pulmonar. CONCLUSIONES. La mortalidad neonatal obedeces a determinantes maternos, obstétricos y feto-neonatales, por lo cual el mejoramiento de los cuidados de estos, reduciría la mortalidad neonatal.

INTRODUCTION. Neonatal death is associated with maternal, obstetric, fetal, neonatal, and health determinants. Objective. To establish the determinants associated with neonatal mortality in a Colombian intensive care unit. METHODS. Case-control study nested in a cohort, where 5567 live infants were included, of which 125 died. Stata 11.0® descriptive statistics were constructed and associations were established using odds ratio (95% confidence interval). Logistic regression was used in the multivariate analysis. A value of p <0.05 was considered significant. RESULTS. Mortality occurred in 2.25% of neonates, with 76.80% of deaths occurring between 0-7 days. Maternal and obstetric determinants independently associated with neonatal mortality included numbers of visits in prenatal control less than 6, spontaneous preterm labor, third trimester bleeding, and chronic hypertension. Among neonatal determinants, the need for cardiorespiratory resuscitation, prematurity or low birth weight, severe bacterial infections, hyaline membrane disease, pulmonary hypertension, congenital malformations and chromosomal abnormalities, and hypertrophic cardiomyopathy were independently associated with neonatal mortality. For complications and adverse events, there was an independent and statistically significant association for infections associated with health care, intravenous haemorrhage degrees III and IV of Papille, and pulmonary hemorrhage. CONCLUSIONS. Neonatal mortality is due to maternal, obstetric and fetal-neonatal determinants, so improving neonatal care will reduce neonatal mortality.