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Very low birth-weight infants: parental visiting and telephoning during initial infant hospitalization.

The purposes of this study were to examine visiting and telephoning patterns of families of very low birth-weight (VLBW) infants during their initial hospitalization and to identify factors related to visiting and telephoning. The sample of 65 VLBW infants (less than or equal to 1,500 gm) and their families was followed for 6 weeks in the special care nurseries. Mothers were the primary visitors, with the typical mother visiting the nursery twice per week. Fathers and other family members made most of their visits in the first few weeks with minimal involvement thereafter. During a typical week the number of telephone calls to the nursery from mothers ranged from one to three. Fathers and other family members made minimal calls. Significantly fewer visits were made by families in which the mother was unmarried, the mother was younger, Medicaid was the type of insurance, annual income was less than $10,000, and private transportation was unavailable. There were no significant relationships between total number of telephone calls made and maternal demographic variables.

Adolescent↗

Sociodemographic factors associated with sleeping position and location.

Recent research has implicated infant sleeping body position and bed sharing as risk factors in the sudden infant death syndrome. The sociodemographic associations of infant sleeping body position and location were examined in this study. This showed that the majority (86.4%) of New Zealand parents now place their infants to sleep on their sides. The remainder place their infants supine (1.3%), prone (4.8%), or no particular way (7.5%). In the waking position, 57.9% were usually found on their sides, 18.2% supine, and 6.1% prone. Infant sleeping position showed marked sociodemographic variability. These findings are a marked contrast to previous New Zealand studies which showed a reversed pattern, with most infants put to sleep prone. There were also highly significant sociodemographic differences in the place of sleeping. Overall 12.2% of infants shared a bed, with infants of younger less well educated mothers who were of non-European origin, with a parity of five or more, or unmarried significantly more likely to do so. Infants of unemployed and lower socioeconomic group (Elley-Irving groups 5 and 6) fathers were also more likely to share a parental bed.

Beds↗

Consequences for infants of parental disagreement in pregnancy intention.

CONTEXT: Despite the well-established literature on couples' pregnancy intentions and on the consequences of unintended pregnancy, the effects of parents' disagreement in fertility intentions has not been explored. Parental disagreement in pregnancy intention, as well as a father's pregnancy intention, may affect infant health. METHODS: Logistic regression analyses using 1979-1992 data from the National Longitudinal Survey of Youth assess effects of unintendedness and parents' disagreement on outcomes related to infants' health and development. Analyses are conducted separately for married and unmarried women; for women of each marital status, one set of analyses includes extensive controls for socioeconomic background, and a second compares effects of intended and unintended pregnancies within the same family. RESULTS: Infants whose conception was intended by their mother but not their father are at elevated risk of adverse health events. When a pregnancy was not intended by the mother, risks are higher than they are if both parents intended the pregnancy, but they differ little according to father's intention. Thus, it may be useful to classify pregnancies as intended by both parents or not intended by at least one. In comparisons of siblings, unintended fertility (so defined) is associated with delayed prenatal care and reduced initiation of breastfeeding. CONCLUSION: Information on both parents' fertility intentions is needed to identify infants at risk of adverse health and developmental outcomes.

Child Development↗

Adolescence and abortion in Greece: women's profile and perceptions.

PURPOSE: To investigate the individual and social profile of the adolescents seeking abortion in Greece. PROCEDURES: Questionnaires were distributed from the obstetricians practicing in the capital and two major cities in Greece to adolescent pregnant women who were seeking for abortion and collected anonymously. MAIN FINDINGS: From 150 consecutive pregnant adolescents, 38 refused to participate and from 112 who accepted to participate only 74 (66%) replied. Most of the respondents lived in a city (65%), were unmarried (73%), 62% had sex first time after the age of 15, and the educational status of their parents was rarely at higher degree (father: 20%, mother: 16%). Among them, 74% declared that they had received information on contraception (64% from friends, 47% from doctors, 36% from the media). Overall, withdrawal (49%) and male condom (28.5%) were the popular contraceptive precautions. Abortion was adolescents' decision in 65%, while the partner's influence in the case of a shared decision was as high as 73%. Most adolescents (91%) knew about the potential risks of abortion mainly by their doctor (87%) and socio-economical reasons (89%) were mostly claimed. Their parents were rarely aware about their pregnancy (28%) and decision for abortion (28%). In most cases it was the first abortion (78%) and adolescents declared that were aware about the Greek Church's opposition (89%) and the existence of an abortion law (86%). PRINCIPAL CONCLUSION: In Greece, the poor education on the issue of contraception still remains a major problem among teenagers contributing to the increased prevalence of undesired pregnancies and abortions.

Abortion, Induced↗

Demographic correlates of paternity confidence and pregnancy outcomes among Albuquerque men.

We examine the demographic correlates of paternity confidence, or men's assessment of the likelihood that they are the genetic father of a particular child. Evolutionary theory predicts that men will provide less parental investment for putative genetic offspring who are unlikely to be their actual offspring, but confidence of paternity has not been as extensively examined as its importance would merit. Using self-reported data on paternity confidence in 3,360 pregnancies reported by men living in Albuquerque, New Mexico, we find that low paternity confidence is more common among unmarried couples and for unplanned pregnancies. We also find that men are more likely not to state paternity confidence (i.e., they refuse to answer the question) if a pregnancy is unplanned. We additionally examine the pregnancy outcomes associated with confidence of paternity. We find that low paternity confidence pregnancies are significantly more likely to be aborted, and pregnancies for which paternity confidence is unstated are more likely to be aborted or to miscarry. Both abortion and miscarriage are associated with unmarried couples, with unplanned pregnancies, and with couples who have fewer children together.

Abortion, Induced↗

Lifestyle factors and prostate cancer risk: a case-control study in Sweden.

We examined associations between lifestyle factors and subsequent risk of prostate cancer in a population-based case-control study. Information on smoking and alcohol habits, socioeconomic factors, marital status, family history, and sexual habits were obtained from a questionnaire and a face-to-face interview with 256 (74.6%) eligible patients and 252 (76.6%) selected controls, frequency matched by age and screened for prostate cancer with negative findings. Unconditional logistic regression was used to estimate the odds ratios (ORs). Risk was elevated among current smokers of cigarettes (OR, 1.8) and current users of hard liquor (OR, 1.4); however, the lack of dose-response trend for both of these exposures argues against a causal association. We found tentative evidence that early first intercourse, a larger number of sexual partners, and other indices of high sexual activity are associated with increased risk. Similarly, adult height, an indicator of nutrition during childhood and adolescence, was weakly positively associated with risk, although larger studies are needed to establish this link. Unmarried men had a lower risk than married men (OR, 0.3), and socioeconomic status did not appear to be strongly associated with prostate cancer. Men with a father who had prostate cancer had a more than 2-fold increased risk of prostate cancer, whereas those with a brother affected had about a 5-folk risk.

Adult↗

Family structure and child abuse.

Knowledge of the characteristics of family structure may be helpful to the pediatrician for predicting child abuse. During the past several decades progressive shifts from the classic family unit of two biological parents and their children to a variety of parental living arrangements have occurred. Most notable are the increases in teenage pregnancies, unmarried motherhood, divorce rates approximating 50% of marriage rates, and frequency of unrelated surrogate parents, most often male, cohabitating in the home. In these settings, identifiable characteristics of the mother, the father or surrogate, the child, the family history, and the immediate neighborhood of the family have been associated with a greater likelihood of child and/or spousal abuse. The accumulated information may be used for preventative intervention.

Adolescent↗

Parental involvement in minors' abortion decisions.

In a 1991 study based on a nationally representative sample of more than 1,500 unmarried minors having an abortion, 61% of the respondents said that one or both of their parents (usually the mother) knew about the abortion. Only 26% of the respondents said their father knew about the abortion; furthermore, 57% of the mothers who knew about their daughter's pregnancy did not tell her father. In this study, which was conducted in states without parental involvement laws in effect, about 75% of the parents who knew about the pregnancy had been told by the daughter herself, and the great majority supported their daughter's decision to have an abortion. Among the minors whose parents found out without being told by the minor, 18% said their parents were forcing them to have an abortion and 6% reported physical violence, being forced to leave home or damage to their parents' health. Minors who did not tell their parents were disproportionately older (aged 16 or 17), white and employed. The minors' most common reasons for not telling their parents were wanting to preserve their relationship with their parents and wanting to protect the parents from stress and conflict. Of those who did not tell their parents, 30% had experienced violence in their family, feared that violence would occur or were afraid of being forced to leave home. Among minors whose parents were unaware of the pregnancy, all consulted someone other than clinic staff about the abortion; most frequently, they consulted their boyfriend (89%), an adult (52%) or a professional (22%).

Abortion, Induced↗

Changes in American A.I.D. practice during the past decade.

We conducted a survey of donor artificial insemination (AID) practices within the United States. The survey document was sent to 360 practitioners listed by national infertility organizations as performing AID. In addition, we queried 100 practices that had responded to a similar survey in 1978. AID was actually performed during the survey year by 167 of the 282 respondents. Relatively few practices (23%) inseminated more than 10 patients per month. Donor payments increased from a mean of $25 to $40 over that period. A significant increase in the use of frozen semen was found. A majority of practices (52%) used a combination of basal body temperature and urinary LH to time inseminations. The fraction of practitioners who inseminated unmarried women increased substantially since the previous survey. The maximum number of pregnancies resulting from a single donor has not changed over the decade. However, on the average, a single donor is fathering fewer children. The percentage (39%) of practices that inseminate women because of genetic disease in the husband's family has remained about the same. Records of donors and AID children were maintained by 40% of the respondents, representing no change from the previous survey. Our data suggest that as many as 23,400 infants may have resulted from AID conceptions during the survey year. Further changes in the practice of AID can be expected as a result of the 1988 federal recommendations that all donor inseminations be undertaken with cryopreserved, quarantined semen.

Congenital Abnormalities↗

Prevalence of and risk factors for sudden infant death syndrome in Canada.

OBJECTIVE: To analyse and describe the prevalence of sudden infant death syndrome (SIDS) in the Canadian population in relation to the distribution of known risk factors for the syndrome. To explain the observed interprovincial variation in SIDS rates. DESIGN: Retrospective population-based case-control study. SETTING: All the provinces and territories of Canada except Quebec. SUBJECTS: The birth and infant death records of singleton births for 1986-88 were linked. The linkage was successful in matching 904 (86%) of the 1053 deaths attributed to SIDS to the birth file for the infant. For each SIDS case three control babies who survived infancy were chosen at random, matched by province of birth. MAIN OUTCOME MEASURES: Infant death classified as a "sudden infant death." Independent variables included infant's sex, birth weight and gestational age, being small for gestational age, mother's age, marital status and parity, and father's age. RESULTS: The risk of SIDS was greater for boys (odds ratio [OR] 1.47, 95% confidence limits [CLs] 1.26 and 1.70) than for girls and was greater for the infants of unmarried women (OR 3.48, 95% CLs 2.94 and 4.11) than for those of married women. The risk of SIDS was inversely related to birth weight (p < 0.001), duration of pregnancy (p < 0.001) and mother's age (up to age 35) (p < 0.001) and was directly related to parity (up to four) (p < 0.001). The available information on birth and death registrations enabled about 30% of deaths from SIDS to be predicted. CONCLUSIONS: Logistic regression equations based on the risk factors available in vital statistics data have low power to predict provincial differences in rates of SIDS. Consequently, there may be additional factors that may explain provincial variation. There is a need for a well-designed case-control study that examines more variables than are available through vital registration systems.

Canada↗

[Passive smoking in children up to 5 years of age].

Passive smoking is a major health risk in young children. We investigated the percentage of children with mothers and/or fathers who reported regular smoking. Data are the national and regional health surveys of the German Cardiovascular Prevention Study (GCP) conducted from 1984 to 1992 in West Germany. 2538 mothers aged 25-40 years were included. The prevalence of passive smoking in children due to smoking mothers was 33.6% 55.4% of the children up to 5 years lived in households with at least one smoking parent member. In 23.4% of these households both parents were smokers. If only one member of the parents smoked this was in two out of three cases the father. 28.2% of mothers with a child younger than one year were current smokers. This prevalence rate increased with the age of the youngest child up to 35.6% for mothers, whose youngest child was 5 years old. Multiple logistic regression analysis was performed to investigate the association between smoking behaviour and the following variables: mother's age, social class, family status, community size and year of the survey. It was found that lower social class members, unmarried or divorced mothers and inhabitants of large cities reported significantly more often regular current smoking. These results underscore the importance of special intervention programs to reduce smoking in parents with young children.

Child, Preschool↗

African American teen mothers' perceptions of parenting.

The purpose of this study was to describe the childbearing African American teens' perceptions of parenting based on their own experiences. Focus group discussions were held with 17 teens in their school setting for 50 minutes each week. Group discussions were audiotaped, tapes were transcribed, and then analyzed for common themes. The unmarried teens ranged in age from 15 to 18 years. Findings indicated that the teens depended on grandmothers to provide child care and for information about parenting. The teens identified parenting problems including crying, discipline, and conflicts dealing with grandmothers and the child's father. Teens wanted more information about breastfeeding and minor childhood diseases. The researchers identified that teens lacked information about their children's growth and development and safety issues. Findings have implications for nurses who care for childbearing teens and their children; and those involved in planning and implementing parent education programs for African American teen mothers and their families. Further research is indicated with larger samples of African American teens; and to explore the context of family relationships in which teen mothers and grandmothers share parenting for the teens' children.

Adaptation, Psychological↗

The 2nd:4th digit ratio, sexual dimorphism, population differences, and reproductive success. evidence for sexually antagonistic genes?

The ratio between the length of the 2nd and 4th digit (2D:4D) is sexually dimorphic, with mean male 2D:4D lower than mean female 2D:4D. It recently was suggested that 2D:4D is negatively correlated with prenatal testosterone and positively correlated with prenatal estrogen. It is argued that high prenatal testosterone and low estrogen (indicated by low 2D:4D) favors the male fetus and low prenatal testosterone and high estrogen (indicated by high 2D:4D) favors the female fetus. The patterns of expression of 2D:4D are interpreted in terms of sexually antagonistic genes.We report data on the following. (a) reproductive success and 2D:4D from England, Germany, Spain, Hungary (ethnic Hungarians and Gypsy subjects), Poland, and Jamaica (women only). Significant negative associations were found between 2D:4D in men and reproductive success in the English and Spanish samples and significant positive relationships between 2D:4D in women and reproductive success in the English, German, and Hungarian samples. The English sample also showed that married women had higher 2D:4D ratios than unmarried women, suggesting male choice for a correlate of high ratio in women, and that a female 2D:4D ratio greater than male 2D:4D predicted high reproductive success within couples. Comparison of 2D:4D ratios of 62 father:child pairs gave a significant positive relationship. This suggested that genes inherited from the father had some influence on the formation of the 2D:4D ratio. Waist:hip ratio in a sample of English and Jamaican women was negatively related to 2D:4D. (b) Sex and population differences in mean 2D:4D in samples from England, Germany, Spain, Hungary (including ethnic Hungarians and Gypsy subjects), Poland, Jamaica, Finland, and South Africa (a Zulu sample). Significant sex and population differences in mean 2D:4D were apparent.

Journal Article↗

School age pregnancies in western Nigeria: parents and products.

Thirty-three babies and their mothers, all school girls, identified out of a total of 576 admissions to the Paediatric unit of the Wesley Guild Hospital, Ilesa , Nigeria over a three month period were studied. Twenty (60.0%) of the babies were newborn, nine (45%) of whom were premature. Jaundice and infections were other common diagnoses in the neonates. Among the 13 children aged over one month protein-energy malnutrition, gastroenteritis and pneumonia were the commonest reasons for admission. Of the total 33, five (38.5%) had had previous admissions and two (6%) died. Both the numbers of premature neonates and of malnourished older children born to young mothers were significantly higher than those of similar aged admissions born to older mothers (P less than 0.001, in both cases). Thirty-two (97%) mothers were unmarried teenagers and there was a disparity between the academic classes and ages at conception in 15 (45.4%) of the mothers. Whilst significant numbers of the mothers were poorly adjusted to the demands of motherhood, varying numbers of the fathers were young, unemployed, in school and negative in their attitudes to the pregnancies and their products. Suggestions are offered for meeting the challenges posed by school age pregnancy and parenthood in a developing country.

Adolescent↗

Psychosocial resources and persistent smoking in early pregnancy--a population study of women in their first pregnancy in Sweden.

STUDY OBJECTIVE: To test the stress hypothesis by characterising women during their first pregnancy who continue to smoke in early pregnancy in comparison with women who quit smoking, with special reference to psychosocial factors like social network, social support, demands, and control in work and daily life. DESIGN: The study is based on a cohort of primigravidas followed during pregnancy. Data were collected by self administered questionnaires during the pregnant womens' first antenatal visit at about 12 weeks. SETTING: The study was performed in the antenatal clinics in the city of Malmö, Sweden. PARTICIPANTS: The participants were all primigravidas living in the city of Malmö, Sweden, over a one year period, 1991-92. A total of 872 (87.7%) of the 994 invited women agreed to participate. The population of this study on smoking includes all primigravidas who at the time of conception were smoking (n = 404, 46.3%). MAIN RESULTS: At the first antenatal visit (63.6% (n = 257) of the prepregnancy smokers were still smoking (a total smoking prevalence of 29.5%). The pregnant smokers were on average younger and had a lower educational level. The highest relative risk (RR) of continued smoking was found among unmarried women RR 2.7 (95% confidence interval) (1.5, 4.8), women having unplanned pregnancies RR 2.2 (1.2, 4.0) and those with a low social participation RR 1.6 (1.0, 2.7), low instrumental support RR 2.6 (1.2, 6.0), low support from the child's father RR 2.1 (1.0, 4.2) and those exposed to job strain RR = 2.3 (1.1, 4.8). The associations were independent of potential confounders such as age, educational level, nationality, cohabiting status, passive smoking, and previous years of smoking. CONCLUSIONS: This study supports the stress hypothesis. Smoking can be one way women handle stress when demands become too great. In order to reduce smoking among pregnant women, maternity centre resources need to be focused more on women with low psychosocial resources who are at highest risk for continued smoking. It is also important to involve actively the woman's partner or other important people in the woman's social network.

Adolescent↗

The future of woman's own name and the transformation of family structures.

The author explores "the changes in attitude [in France] which may have accompanied the recent anti-marriage trend mirrored by the spread of unmarried cohabitation and divorce. She has chosen to investigate opinions in France concerning a secularly one-sided aspect of the marriage system: almost all women take their husband's name when they marry and children are automatically given only their father's name....We...look for signs of change: first, cohortwise, by examining age-specific differences in attitude; second, change related to social groups and the diffusion of new opinions....Finally, we compare these results with data from preceding surveys and suggest what the prospects may be for woman's name."

Attitude↗

Rates of voluntary paternity establishment for infants born to unmarried adolescents.

OBJECTIVE: To investigate factors associated with voluntary paternity establishment for infants born to teenagers. STUDY DESIGN: The medical records of 402 unmarried women aged 13-19 years and delivering between January 1 and July 31, 2000, were reviewed, including prenatal charts, delivery records, birth worksheets, affidavits of parentage and infant birth certificates. The primary outcome was voluntary paternity establishment, as defined by having the father's name on the infant's birth certificate. RESULTS: Separate documents from the medical records of teen mothers had different rates of identifying the father of the infant: 80% of prenatal records had the father's name, as did 76% of birth worksheets and 60% of birth certificates. Maternal age < 16 years was associated with lower rates of paternity establishment as compared with 18-19-year-old mothers (OR 2.9, 95% CI 1.2, 6.7). CONCLUSION: A significant proportion of birth certificates on children born to teenagers do not identify the father of the infant; however, the majority of mothers identified them, on either the prenatal record or birth worksheet. In order to develop effective programs that will affect rates of paternity establishment, we must understand barriers inherent in the process itself.

Adolescent↗

Race and tardive dyskinesia among outpatients at a CMHC.

OBJECTIVE: In a previous study of outpatients with chronic mental illness who were treated with neuroleptic medication, the authors found a higher incidence of tardive dyskinesia among blacks than among whites. In this study the authors examined psychosocial, clinical, treatment, and medical correlates of race that might explain this finding. METHODS: Extensive baseline data were obtained for 398 outpatients at risk for tardive dyskinesia. Pearson and Mantel-Haenszel chi square analyses were used to determine significant associations between a large number of variables and race. RESULTS AND DISCUSSION: Compared with whites, nonwhites were more likely to be younger, less skilled, and unmarried; to report contacts with relatives outside the home; to have a diagnosis of schizophrenia; and to receive higher doses of neuroleptic drugs primarily through depot medications. Nonwhites were less likely to receive nonneuroleptic psychotropics, to wear dentures, and to report social contact with fathers. None of these racial differences explained more than a trivial portion of the association between race and the incidence of tardive dyskinesia. CONCLUSIONS: These results suggest the need for studies of differences in diagnostic and prescribing practices for black and white patients and of differences in the action and side effects of neuroleptics.

Adult↗