Background: Low birth weight (LBW) is an important risk factor for childhood morbidity and mortality, consequently an important public health concern. Aim: This study aims to identify significant socio-economic and nutritional determinants associated with LBW in India. Materials and Methods: Data from 2005 to 2006 National Family Health Survey-3 (NFHS-3) of India was analyzed. A total of 20,946 women (15-49 years) who gave birth at least once 5 years preceding the NFHS-3 were included in this study. Infant's LBW (<2500 grams) as outcome variable was examined in association with all independent predictors as infant's sex, maternal household wealth status, caste, age, education, body mass index (BMI), stature, anemia level, parity, inter-pregnancy interval, antenatal care received, and living place. Results: Almost 20% of the infants were born with LBW. Mother's low education level, BMI <18.5, short stature (height <145 centimeters) and lack of antenatal visits (<4 visits) were significant predictors of LBW. Male gender has a protective effect against LBW. Conclusion: Maternal education, nutritional status and antenatal care received are key determinants that need to be addressed to reduce prevalence of LBW in India. Continue implementation of multifaceted health promotion interventions are needed to address these factors effectively.
There is limited knowledge concerning fall-related activity avoidance in people with Parkinson’s disease (PD); such knowledge would be of importance for the development of more efficient PD-care and rehabilitation. This study aimed to examine how fall-related activity avoidance relates to a history of self-reported falls/near falls and fear of falling (FOF) as well as to disease severity in people with PD. Data were collected from 251 (61 % men) participants with PD; their median (min-max) age and PD duration were 70 (45–93) and 8 (1–43) years, respectively. A self-administered postal survey preceded a home visit which included observations, clinical tests and interview-administered questionnaires. Fall-related activity avoidance was assessed using the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) as well as by using a dichotomous (Yes/No) question. Further dichotomous questions concerned: the presence of FOF and the history (past 6 months) of falls or near falls, followed by stating the number of incidents. Disease severity was assessed according to the Hoehn and Yahr (HY) stages. In the total sample (n = 251), 41 % of the participants reported fall-related activity avoidance; the median mSAFFE score was 22. In relation to a history of fall, the proportions of participants (p < 0.001) that reported fall-related activity avoidance were: non-fallers (30 %), single fallers (50 %) and recurrent fallers, i.e. ≥ 2 falls (57 %). Among those that reported near falls (but no falls), 51 % (26 out of 51) reported fall-related activity avoidance. Of those that reported FOF, 70 % reported fall-related activity avoidance. Fall-related activity avoidance ranged from 24 % in the early PD-stage (HY I) to 74 % in the most severe stages (HY IV-V). Results indicate that fall-related activity avoidance may be related to a history of self-reported falls/near falls, FOF and disease severity in people with PD. Importantly, fall-related activity avoidance is reported among those that do not fall and already in mild PD-stages (HY I-II). Although further studies are needed, our findings indicate that fall-related activity avoidance needs to be addressed early in order to prevent sedentary behavior and participation restrictions.
Introduction: Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context.Methods: This study extracted the children dataset from the 2017–18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis.Results: The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children’s birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition.Conclusion: Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.
1 July 2021 in International Journal of Epidemiology
Background: Previous studies of preterm birth (PTB) concerning night work have been inconclusive and partly limited by imprecise data on working schedules. This study investigated the risk of PTB in relation to detailed, registry-based data on working hours. Methods: In a register-based prospective cohort study, we identified 4970 singleton births with information on PTB from the Swedish Medical Birth Register of health care employees in Stockholm. Day-by-day information on working hours 2008–16 was obtained from a computerized employee register. Odds ratios (ORs) of PTB according to work hour characteristics were analysed by logistic regression adjusted for mother’s age, stature, body mass index (BMI), parity, smoking habits, education, profession and country of birth. Results: There was an increased risk of PTB among those who frequently worked night shifts (>25 times) [OR, 1.62; 95% confidence interval (CI), 1.03–2.53] and who ever worked ≥3 consecutive night shifts (OR, 1.43; 95% CI, 1.03–1.99) during the first trimester. Frequently (> 8 times) working 3 or more consecutive nights, and frequently (>18 times) having quick returns from night shifts (20 times) long shifts (≥10 h) (OR 1.63; 95% CI, 1.07–2.49) during the first trimester and working any Week >40 h (OR 2.05; 95% CI, 1.31–3.22) during the third trimester were associated with PTB. Conclusions: In this cohort of Swedish health care employees with registry-based data on working hours, night work, especially working frequent consecutive nights, and quick returns from night shifts during the first trimester were associated with increased risk of PTB among pregnant women.
Objectives The study aims to differentiate the risk factors of single and multiple concurrent forms of undernutrition among children under 5 in Bangladesh. Design A nationally representative cross-sectional study. Setting Bangladesh. Respondents Children age under 5 years of age. Outcome measure This study considered two dichotomous outcomes: single form (children without single form and with single form) and multiple concurrent forms (children without multiple forms and with multiple forms) of undernutrition. Statistical analysis Adjusted OR (AOR) and CI of potential risk factors were calculated using logistic regression analysis. Results Around 38.2% of children under 5 in Bangladesh are suffering from undernutrition. The prevalence of multiple concurrent forms and single form of child undernutrition was 19.3% and 18.9%, respectively. The key risk factors of multiple concurrent forms of undernutrition were children born with low birth weight (AOR 3.76, 95% CI 2.78 to 5.10); children in the age group 24–35 months (AOR 2.70, 95% CI 2.20 to 3.30) and in the lowest socioeconomic quintile (AOR 2.57, 95% CI 2.05 to 3.23). In contrast, those children in the age group 24–35 months (AOR 1.94, 95% CI 1.61 to 2.34), in the lowest socioeconomic quintile (AOR 1.79, 95% CI 1.45 to 2.21) and born with low birth weight (AOR 1.52, 95% CI 1.11 to 2.08) were significantly associated with a single form of undernutrition. Parental education, father’s occupation, children’s age and birth order were the differentiating risk factors for multiple concurrent forms and single form of undernutrition. Conclusion One-fifth of children under 5 years of age are suffering multiple concurrent forms of undernutrition, which is similar to the numbers suffering the single form. Parental education, father’s occupation, children’s age and birth order disproportionately affect the multiple concurrent forms and single form of undernutrition, which should be considered to formulate an evidence-based strategy for reducing undernutrition among these children.