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Background: In-depth understanding of the transition in the determinants, will aid in comprehending the potential changes in the future, reducing adverse outcomes and supporting ongoing nutrition and health programmes. Most of the studies have studied the determinants at a particular point in time, making it crucial to understand how these determinants have transitioned with the passing years. The present study was conducted to assess the transition in determinants of maternal malnutrition in India over a period of two decades by secondary data analysis using data from national family and health surveys. Methods: For the present exploratory study, secondary data for India was obtained from the DHS program. Data analysis was carried out using SPSS version 20 and above. Thinness [body mass index (BMI) <18.5 kg/m²] was used as the dependent variable. Binary logistic regression analysis was used to ascertain the effects of selected characteristics on the dependent variable and to identify transition in determinants over two decades by comparing the datasets. Results: Determinants of thinness like the place of residence, parity and partner’s occupation remained the same for the first decade however, changed in the last decade to socioeconomic status (OR 4.6: 95% CI [4.2-5.1]), age (OR 4.4: 95% CI [3.7-5.2]) and anemia levels (OR 2.3: 95% CI [2.0-2.7]). Conclusions: The trend clearly indicates that the focus of government programs and policies needs to change and implies that a holistic approach is necessary for improvement.
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Background: Birth weight is a major determinant of child’s health and nutrition. There are various factors which determine birth weight like maternal age, parity, socio economic status etc. A new born weighing less than 2.5 kg is classified as a low birth weight (LBW) baby. Low birth weight can be prevented by improving health status and socio-economic status of the community, improving antenatal care and also by providing proper health education. Methods: A record-based study was carried out in a tertiary care facility of central India. Labour room records from January 2021 to December 2021 were reviewed. The details on birth weight, gender, gestational age, parity, and mode of delivery were obtained and recorded. The data obtained was entered in Microsoft office excel software. Statistical analysis was carried out with the help of open Epi. Results: Out of 4266 records which were studied 46.65% mothers were in the age group 21-25 years and 53.52% were multiparas. The proportion of LBW was found to be 41.30%. LBW was found to have a significant association between age of mother, parity, residence and gender of the baby. Conclusions: In this study, sociodemographic factors, maternal age and multiparity has contributed substantially to LBW. Hospitals should inform pregnant women about the importance of appropriate age at conception. It is high time to discuss the aftereffects of older maternal age in detail and to focus more on biological components underlying these associations.
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Background: Maternal determinants influence the outcome of pregnancy and child’s health in early years. Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures. Methods: Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker. Results: Relevant information could be gathered from 96 caregivers/parents. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p<0.0001). Out of 102 cases under study, minimum recommended 4 ANC visits were not taken by 17 (17.7%) mothers. Also, 13 (13.5%) did not take IFA supplementation. Poor health status during pregnancy, was significantly associated for deficiency disorders of child in later life (p<0.04). Conclusions: Maternal age at pregnancy, health status of mother, ANC care (number of ANC visits, IFA supplementation), health seeking behaviour, birth weight and birth order of child were major determinants of 4Ds.
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@#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.
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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.