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PubMed1994

Levels and correlates of maternal nutritional status in urban Bangladesh.

OBJECTIVE: To determine the levels and correlates of maternal nutritional status. DESIGN: Cross-sectional maternal weight, height, and mid-upper arm circumference (MUAC) data were correlated with sociodemographic data. SETTING: Slums of Dhaka, Bangladesh. SUBJECTS: Weight, height and MUAC were collected from a representative sample of 2417 nonpregnant mothers. Socioeconomic data such as age, education, religion and household economic status was collected from 2048 mothers; data on reproductive experiences such as number of pregnancies and number of children born alive now dead was available from 1314 mothers; and both sets of data from 1185 mothers. METHODS: Using weight, height, MUAC and body mass index (BMI) data, the levels of maternal nutritional status were estimated. Bivariate and multivariate relationships of maternal nutritional status with socioeconomic and reproductive experiences variables were examined. RESULTS: Mothers' mean weight, height, MUAC and BMI were 41.8 kg, 148.8 cm, 232.5 mm, and 18.8 respectively. In multivariate regression analyses, mothers' weight, BMI and MUAC were significantly positively correlated with mothers' years of schooling (P < 0.05) and household economic status (P < 0.01). Mothers' height was significantly positively correlated with years of schooling (P < 0.05), but not with household economic status. Maternal height and weight were significantly negatively correlated with number of child deaths (P < 0.05). CONCLUSIONS: The findings suggest a possible inter-generational effect; thus, improvement of the nutritional status of girls of this generation would improve child survival in the next generation. This, however, will require complex and long-term planning. As an interim measure, shorter mothers should be targeted for appropriate antenatal and obstetric services.

Adult↗
PubMedDate not supplied

Comparison of contraceptive implant adopters and pill users in a family planning clinic in Baltimore.

All 133 women who began using the Norplant contraceptive implant between August and December of 1991 at a Planned Parenthood clinic in Baltimore were compared with a sample of 112 women who obtained prescriptions for the pill at the same clinic during the same time period. A multivariate analysis found that women of Medicaid are significantly more likely than those who are self-paying to select the implant rather than the pill. Similarly, compared with women who have had no children, those who have had two or more are also significantly more likely to choose the implant. However, adolescents and women who have had an abortion are no more likely than other women to select the implant.

Adolescent↗
PubMed1998

Long-term depot medroxyprogesterone acetate (Depo-Provera) use in inner-city adolescents.

PURPOSE: To determine Depo-Provera continuation rates and reasons for its discontinuation among adolescents. STUDY DESIGN: Medical record reviews and telephone interviews with 159 adolescents who initiated Depo-Provera use between 1 December 1992 and 31 December 1995 at two clinics in New York City. Depo-Provera continuation was measured using lifetable analysis. RESULTS: The mean age was 17.7 +/- 1.5 years, with a median of 1 pregnancy (range 0-11). Mean follow-up was 23.4 +/- 10.7 months. Depo-Provera continuation rates were 71% at 3 months, 48% at 6 months, and 27% at 12 months, and were not affected by age, race, pregnancy or contraceptive history, clinic, or foster care status. Forty-three subjects (37% of discontinuers) restarted Depo-Provera during the study period, with a mean time to restart of 8.4 months after the last Depo-Provera injection. Side effects were the main reported reason for Depo-Provera discontinuation, primarily menstrual irregularities (26%) and weight gain (18%). Seventy percent of those discontinuing Depo-Provera owing to irregular bleeding did so after only one injection. For 23%, the single reason for discontinuation was appointment noncompliance. Restart rates were lowest among those who reported irregular bleeding (15%), weight gain (9%), and hair loss (10%), and highest among those discontinuing owing to missed appointments (87%) (p < 0.05). Pregnancies occurred in 19% of Depo-Provera discontinuers. CONCLUSION: Although Depo-Provera continuation rates among adolescents are low, over a third of discontinuers may restart the method. Aggressive management of side effects and assistance with appointment follow-up may improve long-term use. High pregnancy rates warrant close follow-up after Depo-Provera discontinuation.

Adolescent↗
PubMed1997

Effects of marital status on the risk of mortality in poor and non-poor neighborhoods.

PURPOSE: The purpose of this paper is to consider whether the mortality risks associated with marital status are conditioned by the socioeconomic quality of neighborhoods. METHODS: The analysis is based on the first National Health and Nutrition Examination Survey 1971-1974 (NHANES I), and the 1987 NHANES I Epidemiologic Followup Survey (NHEFS). Cox proportional hazards regressions were used to assess whether the effect of marital status on the risk of all-cause and cause-specific mortality is altered by local area poverty. Analyses are stratified by age, sex, and urbanicity. RESULTS: The interaction between neighborhood poverty and marital status is suggested for non-elderly men, particularly for cancer mortality and for men in urban areas. Interaction effects are evident among older women residing in urban areas. CONCLUSIONS: The absence of a spouse elevates the risk of mortality but this risk is moderately higher in impoverished neighborhoods, notably in urbanized areas, for non-elderly men and elderly women. Future studies with larger samples of non-married persons where marital status changes are incorporated are needed to improve our understanding of the joint mortality effects of local area poverty and marital status.

Adult↗
PubMedDate not supplied

Effects of multi-family housing on marital fertility in Iran: population policy implications.

The hypothesis of the relationship between housing types and fertility, which was originally developed and tested in Bogota, Colombia's housing study, is reexamined using Iranian data of urban married women of reproductive age. The findings of the study clearly and consistently show that women living in single-family housing units have significantly higher actual and desired fertility than women living in multi-family housing units, regardless of their major social, economic and demographic differences. Furthermore, the analysis of the relative effects of socioeconomic and demographic variables on fertility indicate that housing types have greater effects on fertility than wife and husband's level of education, when the effects of other variables are controlled. This study implies that crowding and density, which generally are the outcome of high fertility, do have feedback effects causing fertility to decline. This provides some evidence for the hypothesis of self-generating fluctuations in population growth which maintains that a large population will face stiff economic competition, lower incomes, congestion and crowding if other means of production as well as social infrastructure do not expand simultaneously. Finally, this study suggests an optimistic sign of fertility reduction in the large urban populations where the single-family housing units are being replaced by multi-family housing units mainly because of high cost of land, material, and labor, and the shortage of housing units. Most of the large cities in Iran today fit the above descriptions.

Adult↗
PubMed1995

Causes of maternal mortality in a semi-urban Nigerian setting.

Focus group discussions with people in Ekpoma, Nigeria, revealed them to be quite knowledgeable about haemorrhage in pregnancy and delivery. However, because of their inability to recognize early warning signs they continued traditional treatment even when clear evidence of danger existed. Furthermore, they tended not to seek help in clinics and hospitals because of sociocultural conditioning and a negative perception of the quality of care available. There were shortages of materials and adequately trained and committed personnel in the modern health institutions serving the community. An outline is given of the kinds of intervention needed in order to overcome these deficiencies.

Cause of Death↗
PubMed1983

Characteristics and trends of urbanization in a developed Socialist society.

This is a philosophical analysis of the concept of urbanization in the contemporary Marxist setting from the geographical and sociological points of view. "The centripetal forces that used to concentrate industry in cities are said to be yielding to opposed centrifugal forces resulting from a combination of technological, ecological and economic processes. The new centrifugal trend has the effect of helping to restrain the growth of very large cities, a Soviet policy goal, and of giving rise to urban agglomerations." The benefits of the decentralization of urbanization are elaborated.

Communism↗
PubMed1989

Utilization behaviour patterns of Siddha clinics in Salem, Tamil Nadu.

In Tamil Nadu, indigenous Siddha medicine (SM) is officially recognized and extensively used. Yet very little research information or published material is available on the extent of utilization behaviour of Siddha medicine in urban settings. This study examines the current patterns of utilization and consumer behavioural characteristics of SM through a field-based questionnaire survey of a sample of 300 patients attending 15 Siddha clinics in Salem, Tamil Nadu. Four areas were investigated: Socio-economic characteristics of the users; utilization behaviour pattern of patients; reasons for choice of Siddha therapy; opinions, attitudes, perception and satisfaction of users regarding Siddha therapy. The survey points out there is an inverse relationship between the number of patients using SM and income, education and distance travelled. Various factors were cited in choosing SM-such as, effectiveness of treatment, social influences of a relative or friend. Survey indicates that both modern medicine and SM seem to act as supporting rather than as competitive systems in a setting like Salem. People tend to seek both the system in search of a permanent cure.

Adolescent↗
PubMed1982

Mortality and morbidity in infants with intrauterine growth retardation.

This report is based on an analysis of the experience with all births in several urban and rural areas of the United States. All infants whose birth weight was in the lowest quartile for their week of gestation were designated as small for gestational age regardless of their birth weight or length of gestation; other infants were considered appropriate for gestation age. We interpret the data to indicate that appropriate-for-gestational age and small-for-gestational age infants, all of low birth weight, differ in the nature of their risk for adverse outcome as determined by an assessment at one year of age, although both are at approximately equal risk of adverse outcome overall. In each weight group, the total proportion of infants who either died before one year of age or were handicapped at one year of age was similar for small-for-gestational age and appropriate-for-gestational age infants, but appropriate-for-gestational age infants were at greater risk of neonatal death and small-for-gestational age infants were at greater risk of problems manifested during the first year of life or at one year of age. As the findings are based on data obtained from entire populations (rather than from infants born in particular hospitals), they are likely to be generalizable.

Age Factors↗
PubMed1992

Seroepidemiology of cytomegalovirus infection among children between the ages of 4 and 12 years in Taiwan.

To determine risk factors responsible for primary cytomegalovirus (CMV) infection in Taiwan, samples of blood for antibody to CMV were obtained from 362 children aged 4 to 12 years: 58% were found to be positive for anti-CMV IgG antibody. Logistic regression analysis showed that seropositivity correlated with age, method of delivery, duration of breast feeding, and younger age of mother. Neither socioeconomic status nor crowded living conditions showed significant correlation with CMV seropositivity. Primary CMV infection in Taiwan appears to be less related to socioeconomic status shown in western countries, and, since the majority of pregnant women were seropositive in Taiwan, two of the major sources of primary CMV transmission are infected breast milk and the infected genital tract.

Adult↗