Association Between Preterm Delivery and Pre-pregnancy Body Mass (BMI), Exercise and Sleep During Pregnancy Among Working Women in Southern California

Little is known about modifiable lifestyle factors beyond quitting smoking that could prevent preterm delivery (PTD, <37 weeks gestation). We examined the individual and joint associations of pre-pregnancy BMI, second trimester exercise and sleep on PTD. We conducted a nested, population-based case–control study interviewing postpartum 344 cases delivering at <37 weeks, as identified by clinical estimate of gestational age from prenatal screening records, and 698 term controls, excluding term low birthweight. Eligible women participated in California’s statewide Prenatal Screening Program, worked during pregnancy, and delivered a singleton birth in Southern California in 2002–2003. Modeled separately, moderate (odds ratio [OR] = 0.90; 95 % confidence interval [CI] = 0.84–0.96—per hour/week) and vigorous (OR = 0.67; 95 % CI = 0.46–0.98 for yes vs. no) exercise during the second trimester were associated with a reduced odds of PTD, and sleep duration was not (OR = 1.09, 95 % CI = 0.80–1.48 for <7 h; OR = 0.88, 95 % CI = 0.57–1.48 for >8 h vs. 7–8 h). When sleep and exercise variables were modeled together along with pre-pregnancy BMI, only moderate exercise (OR = 0.91; 95 % CI 0.85–0.98) continued to be associated with reduced odds of PTD. The benefits of moderate exercise appeared strongest for women with BMI greater than 24 kg/m² (OR = 0.85; 95 % CI = 0.79–0.93) and weakened with decreasing BMI. No other interactions were found. Moderate exercise is associated with reduced PTD, particularly for women with BMI above the normal range. The results are of public health relevance given that these risk factors are potentially modifiable both pre-conceptionally and during pregnancy and rates of PTD are still high in the United States.     

Prevalence of anemia and associated factors in women of childbearing age in rural Lebanon

Aim

This community-based, cross-sectional survey was conducted to determine the prevalence of anemia and iron deficiency anemia (IDA) and their association with nutritional behavior and other determinants.

Subjects and methods

Arabic-speaking women, aged 15–49 years old, residing in Lebanon’s rural areas were included. Demographic and behavioral characteristics, obstetrical and gynecological history, personal and family medical history, and dietary intake data were collected. Predictors of anemia and IDA were determined using logistic regression.

Results

A total of 578 women were included (Lebanese: 55.2%; Syrian: 43.3%) in which 35.5% had anemia and 23.2% had IDA. The mean number of pregnancies was 3.1 ± 3.0 (number of children: 2.5 ± 2.5). In total, 30% had a personal history of anemia or IDA, 29% a family history of anemia, and 20% a family history of IDA. Iron-rich products were consumed by >?90% of the women, whereby >?66.7% mentioned eating liver, tuna, dates and nuts. Syrian nationality (OR = 2.21; CI 95%: 1.38–3.54), age (OR = 1.03, CI 95%: 1.00–1.06), personal history of anemia (OR = 1.97; CI 95%: 1.31–2.95), consumption of dates (OR = 2.07, CI 95%: 1.29–3.31), molasses (OR = 1.61; CI 95%: 1.03–2.51), and soft drinks >?5 times/week (OR = 1.66; CI 95%: 1.09–2.53) were predictors of anemia. Syrian nationality (OR = 1.73, CI 95%: 1.14–2.62), number of pregnancies (OR = 1.08; CI 95%: 1.01–1.15), period >?8 days (OR = 2.01, CI 95%: 1.07–3.80), consumption of eggs (OR = 0.48; CI 95%: 0.25–0.90), dates (OR = 2.58, CI 95%: 1.49–4.46), and coffee or tea (OR = 1.59, CI 95%: 1.03–2.45) were predictors of IDA.

Conclusion

Anemia and IDA are prevalent in women of childbearing age in rural Lebanon. Intervention programs for raising the population’s awareness about IDA’s risk factors and proper nutrition must be implemented.

     

Predictors and Adverse Pregnancy Outcomes Associated with Antepartum Discharge Against Medical Advice

To determine predictors and pregnancy outcomes associated with antepartum discharge against medical advice (AMA D/C). Retrospective cohort study of state-level maternal and infant hospital discharge data linked to vital statistics data for antepartum admissions in California from 1995 to 2005. (N = 203,250). After adjusting for comorbid conditions, the odds of AMA D/C for Black women were twice that of white women (OR = 2.00, 95 % CI 1.70–2.35). Publicly insured women had 3.5 times the odds of AMA D/C compared to privately insured women (OR = 3.54, 95 % CI 3.02–4.15). AMA D/C was also higher among substance abusers and women with mental illness (OR = 1.96, 95 % CI 1.43–2.67 and OR = 4.45, 95 % CI 3.81–5.21 respectively). Most notably, AMA D/C tripled the odds of fetal death in patients admitted for pregnancy-induced hypertension (OR = 3.08, 95 % CI 1.36–6.98) and increased the odds of neonatal morbidity (respiratory distress syndrome OR = 1.35, 95 % CI 1.07–1.70 and small-for-gestational-age OR = 1.47, 95 % CI 1.15–1.89) in patients admitted with preterm premature rupture of membranes. Vulnerable populations and patients with comorbid medical and mental illnesses are at increased risk for AMA D/C and its associated adverse pregnancy outcomes. Targeted interventions and resources to support at-risk populations are needed.     

The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life

Objective

To evaluate the effects of household use of cleaning products during pregnancy on infant wheezing and lower respiratory tract infections (LRTI).

Methods

In four prospective Spanish birth cohorts (n = 2,292), pregnant women reported the use of household cleaning products. When infants were 12–18 months old, current cleaning product use and infant’s wheezing and LRTI were reported. Cohort-specific associations between the use of specific products and respiratory outcomes were evaluated using multivariable regression analyses and estimates were combined using random-effects meta-analyses.

Results

The period prevalence of LRTI was higher when sprays (combined odds ratio (OR) = 1.29; 95 % confidence interval (CI) 1.04–1.59) or air fresheners (OR = 1.29; CI 1.03–1.63) were used during pregnancy. The odds of wheezing increased with spray (OR = 1.37; CI 1.10–1.69) and solvent (OR = 1.30; CI 1.03–1.62) use. The associations between spray and air freshener use during pregnancy and both outcomes remained apparent when these products were not used after pregnancy. Nevertheless, the estimates were higher when post-natal exposure was included.

Conclusion

The use of cleaning sprays, air fresheners and solvents during pregnancy may increase the risk of wheezing and infections in the offspring.     

Relationship of perceived job strain and workplace support to antenatal depressive symptoms among pregnant employees in Taiwan

Most Taiwanese women continue to work throughout pregnancy. Few studies have investigated the prevalence of antenatal depressive symptoms in employed women and their relationship with work-related factors. We explored the relations of work-related factors, including perceived job strain and workplace support, to depressive symptoms among pregnant Taiwanese employees. During 2015–2016, we interviewed 153 employees in their third trimester of pregnancy using questionnaires to collect data on demographics, pregnancy status, physical conditions, work-related factors, family function, the Edinburgh Postnatal Depression Scale (EPDS), and health-related quality of life (HRQoL). The prevalence of antenatal depressive symptoms, based on EPDS scores≥13, was 13.7%. Pregnant employees with depressive symptoms had lower Family APGAR scores (p < 0.0001) and lower scores on all scales of the HRQoL (p < 0.05). Controlling for covariates, work-related feelings of stress and distress were associated with increased odds of antenatal depressive symptoms (Odds Ratio [OR] = 4.7, 95% confidence Interval [95% CI] = 1.3–19.9). Feeling tired at work (OR = 9.1, 95% CI = 2.3–47.0) and lack of support from colleagues (OR = 16.7, 95% CI = 2.9–53.1) were significantly associated with antenatal depressive symptoms. Such information will facilitate implementation of supportive workplace climates for pregnant employees by employers, supervisors, and occupational and environmental health nurses, which may help improve the health of pregnant employees.     

Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers

Purpose

The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization.

Methods

From 3,710 workers, representative of a French region’s working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling.

Results

Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23–3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41–4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08–3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17–3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01–3.11) for men.

Conclusion

This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.     

Sociocultural hegemony,gendered identity,and use of traditional and complementary medicine in Ghana

ABSTRACT

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ? .0001), and have health insurance (p ? .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28–47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002–0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22–47.60), while females’ TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21–11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78–17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.     

The Relation of Maternal Blood Arsenic to Anemia During Pregnancy

To clarify the relationship of prenatal arsenic exposure to hemoglobin concentrations and anemia during pregnancy, a longitudinal study was conducted of 364 participants during early pregnancy from October 2006 to March 2011 in Tehran, Iran. Maternal whole blood (taken between 8–12 and 20–24 weeks of gestation, and at delivery) and umbilical cord blood samples were collected for arsenic measurement. The mean concentration of maternal blood arsenic in the first trimester of pregnancy was significantly lower in anemic women compared with non-anemic participants (mean ± SD: 12.4 ± 3.4 versus 14.8 ± 4.0 μg/L, respectively, p < 0.001). Maternal whole blood arsenic levels in the first and third trimesters were significantly (p < 0.05) correlated with hemoglobin concentrations measured throughout gestation (r = 0.312, 0.424, and 0.183). Multiple logistic regression analysis demonstrated that increased maternal blood arsenic levels in the first trimester were significantly negatively associated to anemia during pregnancy (OR = 0.85, CI: 0.77–0.94, p < 0.01). The present study showed that prenatal blood arsenic exposure was not a risk factor for the occurrence of anemia.     

Risk of Spontaneous Preterm Birth in Relation to Maternal Exposure to Intimate Partner Violence During Pregnancy in Peru

Intimate partner violence (IPV) is increasingly recognized as an important cause of maternal and perinatal morbidity. We assessed the relation between IPV and risk of spontaneous preterm birth (PTB) among Peruvian women. The study was conducted among 479 pregnant women who delivered a preterm singleton infant (<37 weeks gestation) and 480 controls (≥37 weeks gestation). Participants’ exposure to physical and emotional violence during pregnancy was collected during in-person interviews conducted after delivery and while patients were in hospital. Odds ratios (aOR) and 95 % confidence intervals (CI) were estimated from logistic regression models. The prevalence of any IPV during pregnancy was 52.2 % among cases and 34.6 % among controls. Compared with those reporting no exposure to IPV during pregnancy, women reporting any exposure had a 2.1-fold increased risk of PTB (95 % CI 1.59–2.68). The association was attenuated slightly after adjusting for maternal age, pre-pregnancy weight, and other covariates (OR = 1.99; 95 % CI 1.52–2.61). Emotional abuse in the absence of physical violence was associated with a 1.6-fold (95 % CI 1.21–2.15) increased risk of PTB. Emotional and physical abuse during pregnancy was associated with a 4.7-fold increased risk of PTB (95 % CI 2.74–7.92). Associations of similar directions and magnitudes were observed when PTB were sub-categorized according to clinical presentation or severity. IPV among pregnant women is common and is associated with an increased risk of PTB. Our findings and those of others support recent calls for coordinated global health efforts to prevent violence against women.     

Caffeine intake during pregnancy, late miscarriage and stillbirth

Caffeine is a commonly consumed drug during pregnancy with the potential to affect the developing fetus. Findings from previous studies have shown inconsistent results. We recruited a cohort of 2,643 pregnant women, aged 18–45 years, attending two UK maternity units between 8 and 12 weeks gestation from September 2003 to June 2006. We used a validated tool to assess caffeine intake at different stages of pregnancy and related this to late miscarriage and stillbirth, adjusting for confounders, including salivary cotinine as a biomarker of smoking status. There was a strong association between caffeine intake in the first trimester and subsequent late miscarriage and stillbirth, adjusting for confounders. Women whose pregnancies resulted in late miscarriage or stillbirth had higher caffeine intakes (geometric mean = 145 mg/day; 95% CI: 85–249) than those with live births (103 mg/day; 95% CI: 98–108). Compared to those consuming < 100 mg/day, odds ratios increased to 2.2 (95% CI: 0.7–7.1) for 100–199 mg/day, 1.7 (0.4–7.1) for 200–299 mg/day, and 5.1 (1.6–16.4) for 300+ mg/day (P _trend = 0.004). Greater caffeine intake is associated with increases in late miscarriage and stillbirth. Despite remaining uncertainty in the strength of association, our study strengthens the observational evidence base on which current guidance is founded.     

Socio-Economic Inequalities in Health, Habits and Self-Care During Pregnancy in Spain

Socioeconomic disadvantage can be harmful for mother’s health and can influence child’s health long term. The aim of this study is to analyse social inequalities between pregnant women from four INMA (INfancia y Medio Ambiente) cohorts. The analysis included 2,607 pregnant women recruited between 2004 and 2008 from four INMA cohorts. Data on maternal characteristics were collected through two questionnaires completed in the first and third trimester of pregnancy. The relationship between socioeconomic status (SES) and maternal health, dietary intake, lifestyle habits and self-care related variables was modelled using logistic regression analysis. 33.5 % of women had a university level of education and 47 % had high occupational class. Women with higher SES reported healthier habits, fewer complications during pregnancy, better weight gain control and attended more prenatal appointments than women with lower SES. The risk of sedentary behaviour and passive smoking was higher among women with a lower level of education (OR = 1.7, 95 % CI 1.3–2.2 and OR = 1.6, 95 % CI 1.2–2.3, respectively) and with less skilled occupations (OR = 1.7, 95 % CI 1.4–2.0 and OR = 1.2, 95 % CI 1.0–1.5, respectively). Although both SES indicators—occupation and education—act as social determinants of diet, occupation was a more powerful determinant than education. For other lifestyle and self-caring variables, education was a more powerful predictor than occupation. Social inequalities were observed in health, habits and self-care during pregnancy. Proper care during pregnancy requires the control of common clinical variables and the knowledge of socioeconomic conditions of the pregnant women.     

Communication Predictors of Patient and Companion Satisfaction with Alzheimer’s Genetic Risk Disclosure

The objective of this study was to identify how features of Alzheimer’s disease (AD) genetic risk disclosure communication relate to patient and visit companion satisfaction. We conducted secondary analyses of 79 session recordings from the fourth REVEAL Study, a randomized-controlled trial of AD genetic risk disclosure among patients with mild cognitive impairment. Patient and companion satisfaction were ascertained from postdisclosure surveys. The Roter Interaction Analysis System (RIAS) was used to code triadic communication between the counselor, patient, and companion. High satisfaction was evident for 24% of patients (N = 19) and 48% of companions (N = 38). Multivariate logistic regressions showed that high patient satisfaction was associated with patients’ expression of emotions (OR = 1.1, 95% CI: 1.0–1.1) and companions’ questions about psychosocial and lifestyle topics (OR = 1.8, 95% CI: 1.1–2.8). High companion satisfaction was positively related to the RIAS overall patient-centeredness score for the session (OR = 4.0, 95% CI: 1.0–15.6) (all p-values <0.05). Communication predictors of patient and companion satisfaction reflect specific or summary indicators of patient-centeredness. Findings also suggest that visit companions positively influence patient satisfaction. The study results support the growing literature and policy attention directed toward delivering family-centered care.     

Correlates of Colorectal Cancer Screening Among Residents of Ohio Appalachia

There is an excess burden of colorectal cancer (CRC) in the Appalachian region of the United States, which could be reduced by increased uptake of CRC screening tests. Thus, we examined correlates of screening among Appalachian residents at average-risk for CRC. Using a population-based sample, we conducted interviews with and obtained medical records of Appalachian Ohio residents 51–75 years between September 2009 and April 2010. Using multivariable logistic regression, we identified correlates of being within CRC screening guidelines by medical records. About half of participants were within CRC screening guidelines. Participants who were older (OR = 1.04, 95 % CI 1.01, 1.07), had higher income ($30,000–$60,000, OR = 1.92, 95 % CI 1.29, 2.86; ≥$60,000, OR = 1.80, 95 % CI 1.19, 2.72), a primary care provider (OR = 4.22, 95 % CI 1.33, 13.39), a recent check-up (OR = 2.37, 95 % CI 1.12, 4.99), had been encouraged to be screened (OR = 1.57, 95 % CI 1.11, 2.22), had been recommended by their doctor to be screened (OR = 6.68, 95 % CI 3.87, 11.52), or asked their doctor to order a screening test (OR = 2.24, 95 % CI 1.36, 3.69) had higher odds of being screened within guidelines in multivariable analysis. Findings suggest that access to and utilization of healthcare services, social influence, and patient–provider communication were the major factors associated with CRC screening. Researchers and healthcare providers should develop and implement strategies targeting these barriers/facilitators to improve CRC screening rates and reduce the CRC burden among residents of Appalachia.     

Factors associated with illicit opioid use in methadone maintenance treatment clients in 5 Provinces,China

Objectives

To investigate factors associated with illicit opioid use among methadone maintenance treatment (MMT) population.

Methods

Participants were recruited from Beijing (2 clinics), Shanghai (2 clinics), Guangdong (2 clinics), Chongqing (2 clinics) and Gansu (1 clinic) provinces. Information about heroin use and MMT was obtained from a self-reported questionnaire, illicit opioid use was obtained from monthly medical records. Binary logistic regression was used to investigate factors associated with illicit opioid use.

Results

Five hundred ninety-eight eligible MMT participants were used for data analysis. Variables such as age, gender, route of heroin use and daily MMT dosages were associated with illicit opioid use. Compared with MMT participants aged <40 years, participants aged 40–44 years (P = 0.027, OR = 0.57, 95 % CI 0.35–0.94), 45–49 years (P < 0.001, OR = 0.41, 95 % CI 0.24–0.67) and ≥50 years (P = 0.008, OR = 0.52, 95 % CI 0.33–0.85) were more likely not to have illicit opioid use. Compared with male participants, females were more likely to have illicit opioid use (P = 0.044, OR = 1.53, 95 % CI 1.01–2.32). Compared with inhalation heroin abusers, abusers with route of inhalation + injection heroin use were more likely to have illicit opioid use (P = 0.009, OR = 2.00, 95 % CI 1.19–3.36). Compared with daily MMT dosages <60 mg participants, participants with daily MMT dosages >80 mg were more likely to have illicit opioid use (P = 0.003, OR = 2.37, 95 % CI 1.35–4.15).

Conclusions

Age, gender, route of heroin use and daily MMT dosages were associated with illicit opioid use. A tailored intervention is needed for a promotion of MMT.

     

Least Explored Factors Associated with Prenatal Smoking

Poor pregnancy and birth outcomes are major problems in the United States, and maternal smoking during pregnancy has been identified as one of the most preventable risk factors associated with these outcomes. This study examines less explored risk factors of smoking among underserved African American pregnant women. A cross-sectional survey was conducted at an outpatient obstetrics-gynecology clinic of an inner-city university hospital in Virginia from March 2009 through January 2011 in which pregnant women (N = 902) were interviewed at their first prenatal care visit. Survey questions included items related to women’s sociodemographic characteristics as well as their pregnancy history; criminal history; receipt of social services; child protective services involvement; insurance status; and history of substance abuse, domestic violence, and depression. Multiple logistic regression was conducted to calculate odds ratios and 95 % confidence intervals depicting the relationship between these factors and smoking during pregnancy. The analysis reported that maternal age [OR = 1.08, 95 % CI = 1.05–1.12], less than high school education [OR = 4.30, 95 % CI = 2.27–8.14], unemployed [OR = 2.33, 95 % CI = 1.35–4.04], criminal history [OR = 1.66, 95 % CI = 1.05–2.63], receipt of social services [OR = 2.26, 95 % CI = 1.35–3.79] alcohol use [OR = 2.73, 95 % CI = 1.65–4.51] and illicit drug use [OR = 1.97, 95 % CI = 1.04–3.74] during pregnancy were statistically significant risk factors associated with smoking during pregnancy. In addition to the well known risk factors, public health professionals should be aware that criminal history and receipt of social services are important factors associated with smoking during pregnancy. Social service providers such as WIC and prisons and jails may offer a unique opportunity for education and cessation interventions during the preconception or interconception period.     

Physical Activity Guideline in Mexican-Americans: Does the Built Environment Play a Role?

Given disproportionate burden of physical inactivity among US Hispanics and emerging interests in the potential role of the built environment on physical activity, we tested the hypothesis that residing in a more walkable block group is associated with increased physical activity in a cohort of Mexican-American adults. 10,183 Mexican-American adults from Houston, TX, USA were studied. Physical activity was assessed through self-report. Geographical information systems were used to create a “walkability index” (WI). We examined the relationship between WI and physical activity using regression models. Findings for the entire study population suggested a direct association between neighborhood walkability and physical activity that approached statistical significance (High WI vs. Low WI: OR = 1.16; 95 % CI 0.95–1.40). Furthermore, participants who lived in a higher WI neighborhood were more likely to meet physical activity guidelines in 2 groups: (1) men whose recreational physical activity included walking (High WI vs. Low WI: OR = 5.43; 95 % CI 1.30–22.73) and (2) men whose only recreational physical activity was (High WI vs. Low WI: OR = 9.54; 95 % CI 1.84–49.60). Our findings suggest gender differences in the association between the built environment and physical activity in Mexican-American adults. Attempts to encourage walking among Mexican-American adults may be easier in high-walkability neighborhoods than in low-walkability neighborhoods.     

Reported Maternal Postpartum Depression and Risk of Childhood Psychopathology

Childhood emotional and behavioural disorders are prevalent, can cause significant maladaptation and often persist into adulthood. Previous literature investigating the potential influence of postpartum depression (PPD) is inconsistent. The present study examined the association between PPD and childhood behavioural/emotional outcomes, while considering a number of potentially important factors. Data were analyzed prospectively from the National Longitudinal Survey of Children and Youth at two follow-up periods (ages 2–3, N = 1,452 and ages 4–5, N = 1,357). PPD was measured using the diagnostic criteria of the DSM-IV-TR. Four behavioural/emotional outcomes were analyzed at each follow-up. For both age groups, logistic regression models were used to estimate the associations between PPD and each of the behavioural and emotional outcomes adjusting for child, obstetric, environmental and socio-demographic factors. PPD was associated with the Emotional Disorder-Anxiety among 2–3 year olds [OR = 2.38, 95 % CI 1.15, 4.91]. Among 2–3 year olds, hostile/ineffective parenting was associated with Hyperactivity-Inattention [OR = 1.88, 95 % CI 1.14, 3.11] and Physical Aggression-Opposition [OR = 2.95, 95 % CI 1.77, 4.92]. Among 4–5 year olds, hostile/ineffective parenting was associated with Hyperactivity-Inattention [OR = 2.34, 95 % CI 1.22, 4.47], Emotional Disorder-Anxiety [OR = 2.16, 95 % CI 1.00, 4.67], Physical Aggression-Conduct Disorder [OR = 1.96, 95 % CI 1.09, 3.53] and Indirect Aggression [OR = 1.87, 95 % CI 1.09, 3.21]. The findings of the present study do not suggest that PPD is independently associated with any enduring sequelae in the realm of child behavioural/emotional psychology, though the symptoms of PPD may be giving way to other important mediating factors such as parenting style.     

The Association Between Physical Activity and Maternal Sleep During the Postpartum Period

Physical activity is associated with improved sleep quality and duration in the general population, but its effect on sleep in postpartum women is unknown. We examined cross-sectional and longitudinal associations between hours/week of self-reported domain-specific and overall moderate to vigorous physical activity (MVPA) and sleep quality and duration at 3- and 12-months postpartum among a cohort of 530 women in the Pregnancy, Infection, and Nutrition Postpartum Study. MVPA was not associated with sleep quality or duration at 3-months postpartum. At 12-months postpartum, a 1 h/week increase in recreational MVPA was associated with higher odds of good (vs. poor) sleep quality (odds ratio, OR 1.14; 95 % confidence interval, CI, 1.03–1.27) and a 1 h/week increase in child/adult care MVPA was associated with lower odds of good (vs. poor) sleep quality (OR = 0.93; 95 % CI 0.88–0.99). A 1 h/week increase in child/adult care MVPA (OR 1.08, 95 % CI 1.00–1.16) was associated with higher odds of long sleep duration and 1 h/week increases in indoor household (OR 1.09, 95 % CI 1.01–1.18) and overall MVPA (OR 1.04, 95 % CI 1.01–1.07) were associated with higher odds of short (vs. normal) sleep duration. Comparing 3-months postpartum to 12-months postpartum, increased work MVPA was associated with good sleep quality (OR 2.40, 95 % CI 1.12–5.15) and increased indoor household MVPA was associated with short sleep duration (OR 1.85, 95 % CI 1.05–3.27) as measured at 12-months postpartum. Selected domains of MVPA and their longitudinal increases were associated with sleep quality and duration at 12-months postpartum. Additional research is needed to elucidate whether physical activity can improve postpartum sleep.     

Food Allergy Among Low Birthweight Children in a National Survey

The aim of this paper was to investigate the association between birthweight and prevalence of food allergies using a national sample of US children. Adult report of birthweight and child food allergies were obtained for years 2005–2009 from the National Health Interview Survey (NHIS), a cross-sectional household survey of the US population. A total of 51,748 children aged 0–17 years were included in the analyses representing over 73 million children. Multivariable logistic regression analyses examined associations between birthweight categories and food allergies stratified by age and gender; accounting for the complex design of NHIS. Children aged 6–12 years who were born very low birthweight (500–1,499 g) were more likely to have reported food allergy compared to referent (3,000–3,499 g), OR = 1.72; 95% CI: 1.02–2.91. However, there was no clear trend of an association between birthweight and food allergy with increasing or decreasing birthweight across all ages. Estimates were generally stronger in younger male children as compared to estimates in females of the same age group. Marginal associations for respiratory allergy (OR = 1.52; 95% CI: 1.02–2.29) and hay fever (OR = 1.54; 95% CI: 0.93–2.54) were observed among very low birthweight children aged 0–5 years. There was limited evidence for a clear association between birthweight and food allergy. Marginal associations observed in children weighing 500–1,499 g at birth support efforts to minimize preterm births and very low birthweight given the increase in pediatric food allergies and the large number of children born low birthweight each year in the US.     

Impact of household solid fuel use on blood pressure and hypertension among adults in China

The widespread use of solid fuel as primary household energy resource has been demonstrated to be linked to significant adverse health effects. However, limited studies examined the cardiovascular-related health effects of household solid fuel exposure, especially from the view of blood pressure (BP) measurements, a leading risk factor for cardiovascular diseases. Using a large-scale population-based data, this study evaluated the association between household solid fuel exposure and adults’ blood pressure as well as hypertension in nine provinces of China. Multiple linear regression and logistic regression models were used to estimate the coefficients, odd ratios (ORs), and the corresponding 95 % confidence intervals (CI). After adjusting for potential confounders, we observed a 0.75 % (95 % CI 0.74–0.76 %, p < 0.05) higher systolic blood pressure (SBP) and 1.05 % (95 % CI 1.04–1.06 %, p < 0.01) higher diastolic blood pressure (DBP) in current solid fuel users. Users with longest duration of solid fuel exposure had a 1.63 % (95 % CI 1.62–1.64 %, p < 0.01) higher SBP and 1.31 % (95 % CI 1.30–1.32 %, p < 0.01) higher DBP than non-users. Besides, current use of solid fuel also was associated with an increased risk for hypertension (OR = 1.11, 95 % CI 1.11–1.12 %). Compared with non-users, those with the longest duration of solid fuel also experienced a larger risk of hypertension with an OR of 1.55 (95 % CI 1.54–1.56 %). The findings suggest that solid fuel exposure may link to higher blood pressure and elevated risk of hypertension in adults in China.