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Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 43939

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Special Issue Editors

Prof. Dr. Shahirose Premji

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Guest Editor

Department of Psychology, School of Nursing, York University, 104 Scholars Walk, Room 313 Health, Nursing and Environmental Studies, Toronto, ON M3J 1P3, Canada
Interests: maternal and newborn health; perinatal health with focus on maternal and infant mental health; preterm birth, complex psychosocial, biological, and behavioral interactions; community-based care of preterm infants, especially late preterm infants

Dr. Aliyah Dosani

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Guest Editor

School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB T3E 6K6, Canada
Interests: social justice and health equity; maternal, newborn, and child health, specifically working with at risk populations through community-based programs and interventions

Special Issue Information

Dear Colleagues,

The International Journal of Environmental Research and Public Health is publishing a Special Issue titled “Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health”. For detailed information on the journal, I refer you to https://www.mdpi.com/journal/ijerph.

Maternal, infant, and child health has been on the global public health agenda for several decades. The fifth Millennium Development Goal (MDG) was dedicated to improving maternal health by reducing maternal mortality and ensuring universal access to reproductive health by encouraging the use of skilled birth attendants (United Nations, 2015). While maternal health is less prominent in the Sustainable Development Goals (SDG), it is still recognized as a priority in SDG # 3 (Good Health and Wellbeing), requiring sustained investment (United Nations, 2019). While progress has been made, we still have a long way to go all over the world. We know that there are several intersections that impact perinatal health that also require our attention. Some of these factors include racial differences, mental health, physical environmental disasters/conditions, human rights, and more broadly, access to the social determinants of health. We know that the experiences of the mother and the conditions in which she finds herself in during pregnancy will impact pregnancy outcomes and the health of her infant as they grow. In this Special Issue, we invite you to share your work with a global audience and together we can shed light on the directions we need to take to positively impact perinatal health at the global level. The keywords listed below provide some of the possible areas of interest.

Prof. Dr. Shahirose Premji
Dr. Aliyah Dosani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Perinatal mental health
Child growth development
Early brain development
Social environment
Sociocultural, biological mediators
Resilience
Racial differences
Chronic and acute stress
Screening
Interventions
Public health
Global health
Multimorbidity
Epidemiology
Power dynamics
Relationships

Published Papers (10 papers)

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Research

Jump to: Review

8 pages, 311 KiB

Open AccessArticle

Screening for Autism Spectrum Disorder in Premature Subjects Hospitalized in a Neonatal Intensive Care Unit

by Norrara Scarlytt de Oliveira Holanda, Lidiane Delgado Oliveira da Costa, Sabrinne Suelen Santos Sampaio, Gentil Gomes da Fonseca Filho, Ruth Batista Bezerra, Ingrid Guerra Azevedo and Silvana Alves Pereira

Int. J. Environ. Res. Public Health 2020, 17(20), 7675; https://doi.org/10.3390/ijerph17207675 - 21 Oct 2020

Cited by 3 | Viewed by 2624

Abstract

Considering that the average age for diagnosis of autism spectrum disorder (ASD) is 4–5 years, testing screening methods for ASD risk in early infancy is a public health priority. This study aims to identify the risks for development of ASD in children born prematurely and hospitalized in a neonatal intensive care unit (NICU) and explore the association with pre-, peri- and postnatal factors. Methods: The children’s families were contacted by telephone when their child was between 18 and 24 months of age, to apply the Modified Checklist for Autism in Toddlers (M-CHAT). The sample consisted of 40 children (57.5% boys). M-CHAT screening revealed that 50% of the sample showed early signs of ASD. Although the frequency of delayed development was higher in boys, this difference was not statistically significant between the sexes (p = 0.11). Assessment of the association between perinatal conditions and early signs of autism in children hospitalized in an NICU exhibited no correlation between the factors analyzed (birth weight and type of delivery). The findings indicate a high risk of ASD in premature children, demonstrating no associations with gestational and neonatal variables or the hospitalization conditions of the NICUs investigated. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

11 pages, 480 KiB

Open AccessArticle

Preconception Care among Pregnant Women in an Urban and a Rural Health Facility in Kenya: A Quantitative Study

by Joan Okemo, Marleen Temmerman, Mukaindo Mwaniki and Dorothy Kamya

Int. J. Environ. Res. Public Health 2020, 17(20), 7430; https://doi.org/10.3390/ijerph17207430 - 13 Oct 2020

Cited by 6 | Viewed by 3975

Abstract

Preconception care (PCC) aims to improve maternal and fetal health outcomes, however, its utilization remains low in developing countries. This pilot study assesses the level and determinants of PCC in an urban and a rural health facility in Kenya. Unselected pregnant women were recruited consecutively at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The utilization of PCC was defined as contact with any health care provider before current pregnancy and addressing pregnancy planning and preparation. A cross-sectional approach was employed and data were analyzed using SPSS version 22. 194 participants were recruited (97 in each setting) of whom, 25.8% received PCC. Age, marital status, education, parity and occupation were significant determinants of PCC uptake. There was also a significant difference in PCC uptake between the rural (16.5%) and urban (35.1%) participants (p < 0.01), OR of 0.3 (0.19–0.72, 95% CI). The low level of PCC in Kenya revealed in this study is consistent with the low levels globally. However, this study was not powered to allow firm conclusions and analyze the true effects of PCC determinants. Therefore, further research in the field is recommended in order to inform strategies for increasing PCC utilization and awareness in Kenya. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

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12 pages, 358 KiB

Open AccessArticle

Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress

by Shahirose Sadrudin Premji, Sharifa Lalani, Kiran Shaikh, Ayesha Mian, Ntonghanwah Forcheh, Aliyah Dosani, Nicole Letourneau, Ilona S. Yim, Shireen Shehzad Bhamani and MiGHT (Maternal-Infant Global Health Team—Collaborators in Research)

Int. J. Environ. Res. Public Health 2020, 17(19), 7295; https://doi.org/10.3390/ijerph17197295 - 06 Oct 2020

Cited by 15 | Viewed by 3185

Abstract

Anxiety and depression commonly co-occur during pregnancy and may increase risk of poor birth outcomes including preterm birth and low birth weight. Our understanding of rates, patterns, and predictors of comorbid anxiety and depression is hindered given the dearth of literature, particularly in low- and middle-income (LMI) countries. The aim of this study is (1) to explore the prevalence and patterns of comorbid antenatal anxiety and depressive symptoms in the mild-to-severe and moderate-to-severe categories among women in a LMI country like Pakistan and (2) to understand the risk factors for comorbid anxiety and depressive symptoms. Using a prospective cohort design, a diverse sample of 300 pregnant women from four centers of Aga Khan Hospital for Women and Children in Pakistan were enrolled in the study. Comorbid anxiety and depression during pregnancy were high and numerous factors predicted increased likelihood of comorbidity, including: (1) High level of perceived stress at any time point, (2) having 3 or more previous children, and (3) having one or more adverse childhood experiences. These risks were increased if the husband was employed in the private sector. Early identification and treatment of mental health comorbidities may contribute to decreased adverse birth outcomes in LMI countries. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

13 pages, 327 KiB

Open AccessArticle

Psychosocial Experiences of HIV-Positive Women of African Descent in the Cultural Context of Infant Feeding: A Three-Country Comparative Analyses

by Josephine Etowa, Hilary Nare, Doris M. Kakuru and Egbe B. Etowa

Int. J. Environ. Res. Public Health 2020, 17(19), 7150; https://doi.org/10.3390/ijerph17197150 - 29 Sep 2020

Cited by 5 | Viewed by 2264

Abstract

Infant feeding among mothers of African descent living with Human Immunodeficiency Virus (HIV) is a critical practice that is influenced by policies, cultural expectations, and the resultant psychosocial state of the mother. Hence, this paper draws insights from a broader infant feeding study. It provides insights into how guidelines on infant feeding practices, cultural expectations, migration, or geographic status intersect to influence the psychosocial experiences of mothers living with HIV. We compared psychosocial experiences of Black mothers of African descent living with HIV in Nigeria versus those in high-income countries (Canada and USA), in the context of contrasting national infant feeding guidelines, cultural beliefs about breastfeeding, and geographic locations. Survey was conducted in venue-based convenience samples in two comparative groups: (Ottawa, Canada and Miami-FL, USA combined [n = 290]), and (Port Harcourt, Nigeria [n = 400]). Using independent samples t-statistics, we compared the means and distributions of six psychosocial attributes between Black mothers in two distinct: Infant feeding groups (IFGs), cultural, and geographical contexts at p < 0.05. Psychosocial attributes, such as discrimination and stigma, were greater in women who exclusively formula feed (EFF) than in women who exclusively breastfeed (EBF) at p < 0.01. Heightened vigilance, discrimination, and stigma scores were greater in women whose infant feeding practices were informed by cultural beliefs (CBs) compared to those not informed by CBs at p < 0.001. Discrimination and stigma scores were greater among mothers in Canada and the USA than in Nigeria at p < 0.001. Heightened vigilance and perceived stress scores were less among women in Canada and the USA than in Nigeria at p < 0.001. The guidelines on infant feeding practices for mothers with HIV should consider cultural expectations and migration/locational status of mothers. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

13 pages, 311 KiB

Open AccessArticle

Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities

by Josephine Etowa, Egbe Etowa, Hilary Nare, Ikenna Mbagwu and Jean Hannan

Int. J. Environ. Res. Public Health 2020, 17(18), 6893; https://doi.org/10.3390/ijerph17186893 - 21 Sep 2020

Cited by 4 | Viewed by 2936

Abstract

The study is motivated by the need to understand the social determinants of breastfeeding attitudes among HIV-positive African, Caribbean, and Black (ACB) mothers. To address the central issue identified in this study, analysis was conducted with datasets from two North American cities, where unique country-specific guidelines complicate infant feeding discourse, decisions, and practices for HIV-positive mothers. These national infant feeding guidelines in Canada and the US present a source of conflict and tension for ACB mothers as they try to navigate the spaces between contradictory cultural expectations and national guidelines. Analyses in this paper were drawn from a broader mixed methods study guided by a community-based participatory research (CBPR) approach to examine infant feeding practices among HIV-positive Black mothers in three countries. The survey were distributed through Qualtrics and SPSS was used for data cleaning and analysis. Results revealed a direct correlation between social determinants and breastfeeding attitude. Country of residence, relatives’ opinion, healthcare providers’ advice and HIV-related stigma had statistically significant association with breastfeeding attitude. While the two countries’ guidelines, which recommend exclusive formula feeding, are cardinal in preventing vertical transmission, they can also be a source of stress. We recommend due consideration of the cultural contexts of women’s lives in infant feeding guidelines, to ensure inclusion of diverse women. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

17 pages, 800 KiB

Open AccessArticle

by Robyn Brunton, Nicole Simpson and Rachel Dryer

Int. J. Environ. Res. Public Health 2020, 17(18), 6709; https://doi.org/10.3390/ijerph17186709 - 15 Sep 2020

Cited by 27 | Viewed by 4085

Abstract

Pregnancy-related anxiety is contextualised by pregnancy and is a health concern for the mother and child. Perceived parental self-efficacy is associated with this anxiety and age and parity are identified as influential factors. This research, therefore, predicted that negative perceptions of parental self-efficacy would predict greater pregnancy-related anxiety, moderated by parity and age. Participants (N = 771) were recruited online and assessed for perceived parental self-efficacy, pregnancy-related anxiety, and demographics. Moderation models showed that the psychosocial and sociodemographic factors combined predicted up to 49% of the variance. Parental self-efficacy predicted anxiety in the areas of body image, worry about themselves, baby concerns, pregnancy acceptance, attitudes towards medical staff and childbirth, and avoidance. Parity predicted pregnancy-related anxiety both overall and in childbirth concerns, worry about self, baby concerns and attitudes towards childbirth. Age predicted baby concerns. There was a significant moderation effect for pregnancy acceptance indicating that primiparous women with low perceptions of parental self-efficacy are less accepting of their pregnancy. Results suggest that parity and parental self-efficacy may be risk factors for first-time mothers for pregnancy-related anxiety. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

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12 pages, 542 KiB

Open AccessArticle

Adverse Childhood Experiences and Changing Levels of Psychosocial Distress Scores across Pregnancy in Kenyan Women

by Pauline Samia, Shahirose Premji, Farideh Tavangar, Ilona S. Yim, Sikolia Wanyonyi, Mohamoud Merali, Wangira Musana, Geoffrey Omuse, Ntonghanwah Forcheh, Aliyah Dosani, Nicole Letourneau and MIGHT Consortium

Int. J. Environ. Res. Public Health 2020, 17(10), 3401; https://doi.org/10.3390/ijerph17103401 - 13 May 2020

Cited by 15 | Viewed by 3033

Abstract

Background: Adverse childhood experiences (ACEs) have been associated with deleterious effects on mental health in pregnancy. Methods: The ACE International Questionnaire (ACE-IQ) was used to measure neglect, abuse, and household dysfunction. Longitudinal mixed effect modelling was used to test the effect of ACEs on pregnancy-related anxiety, depressive symptoms, and perceived stress at two time points (12–19 and 22–29 weeks) during pregnancy. Results: A total of 215 women who were predominantly married (81%) and had attained tertiary education (96%) were enrolled. Total ACEs were significantly associated with depressive symptoms (r = 0.23, p < 0.05) and perceived stress (r = 0.18, p < 0.05). As depressive symptoms decreased, t (167) = −8.44, p < 0.001, perceived stress increased, t (167) = 4.60, p < 0.001, and pregnancy-related anxiety remained unchanged as pregnancy progressed. Contact sexual abuse (p < 0.01) and parental death or divorce (p = 0.01) were significantly associated with depression over time (p < 0.01). Total ACEs in this study were associated with depressive symptoms early but not late in pregnancy. Conclusions: Higher total ACEs were positively associated with depressive symptoms and perceived stress during pregnancy, suggesting that mental disorders may have an impact on pregnancy outcomes and ought to be addressed. Further validation of the Edinburgh Postnatal Depression Scale (EPDS) tool in local settings is required. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

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Review

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48 pages, 789 KiB

Open AccessReview

Interpersonal Psychotherapy to Reduce Psychological Distress in Perinatal Women: A Systematic Review

by Katherine S. Bright, Elyse M. Charrois, Muhammad Kashif Mughal, Abdul Wajid, Deborah McNeil, Scott Stuart, K. Alix Hayden and Dawn Kingston

Int. J. Environ. Res. Public Health 2020, 17(22), 8421; https://doi.org/10.3390/ijerph17228421 - 13 Nov 2020

Cited by 23 | Viewed by 5374

Abstract

Background: Interpersonal psychotherapy (IPT) is a psychological intervention with established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of wellbeing. There is limited information regarding moderating and mediating factors that impact the effectiveness of IPT such as the timing of the intervention or the mode of delivery of IPT intervention. The overall objective of this systematic review was to evaluate the effectiveness of IPT interventions to treat perinatal (from pregnancy up to 12 months postpartum) psychological distress. Methods: MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (OVID), CINAHL with Full Text (Ebsco), Social Work Abstracts (Ebsco), SocINDEX with Full Text (Ebsco), Academic Search Complete (Ebsco), Family & Society Studies Worldwide (Ebsco), Family Studies Abstracts (Ebsco), and Scopus databases were searched from inception until 31 January 2019. Two researchers independently screened articles for eligibility. Of the 685 screened articles, 43 met the inclusion criteria. The search was re-run on 11 May 2020. An additional 204 articles were screened and two met the inclusion criteria, resulting in a total of 45 studies included in this review. There were 25 Randomized Controlled Trials, 10 Quasi-experimental studies, eight Open Trials, and two Single Case Studies. All included studies were critically appraised for quality. Results: In most studies (n = 24, 53%), the IPT intervention was delivered individually; in 17 (38%) studies IPT was delivered in a group setting and two (4%) studies delivered the intervention as a combination of group and individual IPT. Most interventions were initiated during pregnancy (n = 27, 60%), with the remaining 18 (40%) studies initiating interventions during the postpartum period. Limitations: This review included only English-language articles and peer-reviewed literature. It excluded government reports, dissertations, conference papers, and reviews. This limited the access to grassroots or community-based recruitment and retention strategies that may have been used to target smaller or marginalized groups of perinatal women. Conclusions: IPT is an effective intervention for the prevention and treatment of psychological distress in women during their pregnancy and postpartum period. As a treatment intervention, IPT is effective in significantly reducing symptoms of depression and anxiety as well as improving social support, relationship quality/satisfaction, and adjustment. Systematic Review Registration: PROSPERO CRD42019114292. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

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18 pages, 840 KiB

Open AccessReview

mHealth and Perinatal Depression in Low-and Middle-Income Countries: A Scoping Review of the Literature

by Aliyah Dosani, Harshmeet Arora and Sahil Mazmudar

Int. J. Environ. Res. Public Health 2020, 17(20), 7679; https://doi.org/10.3390/ijerph17207679 - 21 Oct 2020

Cited by 14 | Viewed by 3767

Abstract

Women in low- and middle-income countries have high rates of perinatal depression. As smartphones become increasingly accessible around the world, there is an opportunity to explore innovative mHealth tools for the prevention, screening, and management of perinatal depression. We completed a scoping review of the literature pertaining to the use of mobile phone technologies for perinatal depression in low-and middle-income countries. PubMed CINHAL, and Google Scholar databases were searched, generating 423 results. 12 articles met our inclusion criteria. Two of the 12 articles reviewed mobile phone applications. The remaining 9 articles were study protocols or descriptive/intervention studies. Our results reveal that minimal literature is currently available on the use of mobile health for perinatal depression in low- and middle-income countries. We found four articles that present the results of an intervention that were delivered through mobile phones for the treatment of perinatal depressive symptoms and an additional qualitative study describing the perceptions of mothers receiving cognitive behavioral therapy via telephones. These studies demonstrated that depressive symptoms improved after the interventions. There is potential to improve the quality of mHealth interventions, specifically mobile phone applications for perinatal depressive symptoms and depression, through meaningful collaborative work between healthcare professionals and application developers. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

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19 pages, 1064 KiB

Open AccessReview

Reorienting Nurturing Care for Early Childhood Development during the COVID-19 Pandemic in Kenya: A Review

by Constance Shumba, Rose Maina, Gladys Mbuthia, Rachel Kimani, Stella Mbugua, Sweta Shah, Amina Abubakar, Stanley Luchters, Sheila Shaibu and Eunice Ndirangu

Int. J. Environ. Res. Public Health 2020, 17(19), 7028; https://doi.org/10.3390/ijerph17197028 - 25 Sep 2020

Cited by 16 | Viewed by 11939

Abstract

In Kenya, millions of children have limited access to nurturing care. With the Coronavirus disease 2019 (COVID-19) pandemic, it is anticipated that vulnerable children will bear the biggest brunt of the direct and indirect impacts of the pandemic. This review aimed to deepen understanding of the effects of COVID-19 on nurturing care from conception to four years of age, a period where the care of children is often delivered through caregivers or other informal platforms. The review has drawn upon the empirical evidence from previous pandemics and epidemics, and anecdotal and emerging evidence from the ongoing COVID-19 crisis. Multifactorial impacts fall into five key domains: direct health; health and nutrition systems; economic protection; social and child protection; and child development and early learning. The review proposes program and policy strategies to guide the reorientation of nurturing care, prevent the detrimental effects associated with deteriorating nurturing care environments, and support the optimal development of the youngest and most vulnerable children. These include the provision of cash transfers and essential supplies for vulnerable households and strengthening of community-based platforms for nurturing care. Further research on COVID-19 and the ability of children’s ecology to provide nurturing care is needed, as is further testing of new ideas. Full article

(This article belongs to the Special Issue Early Fetal Environment to Infancy: Setting the Stage for Lifelong Health)

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