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Special Issue "Maternal and Child Health 2018"

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 (30 April 2018)

Special Issue Editor

Guest Editor
Dr. Yap-Seng Chong

Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
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Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on maternal and child health in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph

Environmental exposure in early life to factors including nutrition, parental physiology, psychological state, behaviour and environmental toxins, can alter developmental trajectories and render risk for compromised metabolic and mental health. Attention to the health of both mother and child, particularly at key life stages, will alter an individual’s subsequent risk for chronic illness or impaired development. Promoting a healthy start to life can reduce the long-term potential for adverse developmental outcomes. 

This Special Issue is open to any subject area related to maternal and child health. The listed keywords suggest just a few of the many possibilities. We look forward to your active contribution to this issue.

Dr. Yap-Seng Chong
Guest Editor

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 papers will be 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 semimonthly 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 1800 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

  • Environmental health
  • Nutrition
  • Social determinants of health
  • Pregnancy
  • Child growth
  • Non-communicable diseases
  • Metabolic disease
  • Neurodevelopment
  • Developmental Origin of Health and Diseases
  • Epigenetics

Published Papers (17 papers)

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Research

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Open AccessArticle
Maternal Serum and Breast Milk Adiponectin: The Association with Infant Adiposity Development
Int. J. Environ. Res. Public Health 2018, 15(6), 1250; https://doi.org/10.3390/ijerph15061250
Received: 29 April 2018 / Revised: 8 June 2018 / Accepted: 11 June 2018 / Published: 12 June 2018
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Abstract
The prevalence of childhood obesity is increasing at an alarming rate in Malaysia. Metabolic changes during pregnancy are critical to the development of infant adiposity, due to imbalanced adipokines production. Hence, we aimed to investigate the association of maternal serum and breast milk [...] Read more.
The prevalence of childhood obesity is increasing at an alarming rate in Malaysia. Metabolic changes during pregnancy are critical to the development of infant adiposity, due to imbalanced adipokines production. Hence, we aimed to investigate the association of maternal serum and breast milk adipokines with infant adiposity development. The study was conducted from April 2010 until December 2012. A total of 155 healthy pregnant mothers aged 19 to 40 years were recruited during the first and second trimester in Kelantan, Malaysia. Data consisted of maternal sociodemographic details, anthropometry and clinical biochemistry analysis; and the infant’s anthropometry and feeding patterns. Maternal fasting serum and breast milk samples were analysed for adiponectin and leptin levels. Data collection was performed in the second and third trimester of pregnancy, and continued with follow-up visits at birth, two, six, and 12 months postpartum. Multiple linear regression (MLR) analyses were performed to examine the associations between maternal serum and breast milk adiponectin and leptin and infant adiposity development. MLR models showed that, in the first year, as maternal serum and breast milk adiponectin increased, infant weight, BMI-for-age Z scores and abdominal circumference significantly decreased (p < 0.05). Maternal serum and/or breast milk adiponectin was associated with first-year infant adiposity development. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Open AccessArticle
Vitamins A and E during Pregnancy and Allergy Symptoms in an Early Childhood—Lack of Association with Tobacco Smoke Exposure
Int. J. Environ. Res. Public Health 2018, 15(6), 1245; https://doi.org/10.3390/ijerph15061245
Received: 24 April 2018 / Revised: 30 May 2018 / Accepted: 7 June 2018 / Published: 12 June 2018
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Abstract
Epidemiological studies have suggested an association between maternal antioxidant levels during pregnancy and development of allergic diseases in their offspring. The aim of the study was to determine plasma vitamins A and E concentration in the 1st trimester of pregnancy, at delivery and [...] Read more.
Epidemiological studies have suggested an association between maternal antioxidant levels during pregnancy and development of allergic diseases in their offspring. The aim of the study was to determine plasma vitamins A and E concentration in the 1st trimester of pregnancy, at delivery and in cord blood and to search for a relationship with allergy in up to 2-year-old children who were prenatally exposed or not exposed to tobacco smoke. The study participants included 252 mother-child pairs from Polish Mother and Child Cohort. Vitamin concentrations were measured using the HPLC-UV method, smoking status—as saliva cotinine level using the HPLC-MS/MS technique. Children’s health status was assessed using a questionnaire and pediatricians/allergists examination. Cord plasma vitamin concentrations were significantly lower than their levels in maternal plasma in the 1sttrimester and at delivery (p < 0.001). Significantly higher concentrations of vitamin E have been shown to occur during the 1st trimester of pregnancy in plasma of the women who have actively/passively smoked cigarettes compared to the non-smokers (p < 0.02). Multivariate analysis with inclusion of a variety of confounding factors have not indicated any statistically significant associations between β-carotene, vitamins A and E and the risk of food allergy, atopic dermatitis and wheezing in their children up to 2 years of age. The interaction between smoking during pregnancy and vitamins levels on the risk of allergy was not statistically significant (p < 0.4). The relationship between plasma concentration of vitamins A and E, and the risk of allergy in their young children has not been demonstrated. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Open AccessArticle
Prenatal Perfluorooctyl Sulfonate Exposure and Alu DNA Hypomethylation in Cord Blood
Int. J. Environ. Res. Public Health 2018, 15(6), 1066; https://doi.org/10.3390/ijerph15061066
Received: 30 April 2018 / Revised: 18 May 2018 / Accepted: 21 May 2018 / Published: 24 May 2018
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Abstract
Background: Perfluoroalkyl substances (PFASs) are stable and persistent in the environment, animals, and humans. PFASs can penetrate placenta and affect fetal growth. We investigated associations between prenatal exposure to perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluoroundecanoic acid (PFUA) and [...] Read more.
Background: Perfluoroalkyl substances (PFASs) are stable and persistent in the environment, animals, and humans. PFASs can penetrate placenta and affect fetal growth. We investigated associations between prenatal exposure to perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluoroundecanoic acid (PFUA) and global methylation levels. Specific Aims and Methods: The study used the subjects from Taiwan Birth Panel birth cohort study, including all pregnant women who gave birth between July 2004 and June 2005 in four hospitals in Taipei city and New Taipei City. A total of 363 mother-infant pairs were included in the final analyses. PFOA, PFOS, PFNA, and PFUA were measured by UPLC-MS/MS in cord blood. LINE-1 and Alu repeated elements from cord blood was used to represent global DNA methylation levels. Multivariable regression models were used to adjust potential confounders. Results: After controlling for potential confounders, each unit increase in the natural log-transformed PFOS exposure was associated with an adjusted OR of 1.72 (95% CI: 1.03, 2.88) for low Alu methylation level when dichotomized methylation level by medium. No significant effects between PFOA, PFNA, PFUA and methylation levels in the multivariable regression models were observed. Conclusions: Our findings suggest that prenatal PFOS exposure may be associated with low Alu methylation level. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Open AccessFeature PaperArticle
Pregnancy Trimester-Specific Exposure to Ambient Air Pollution and Child Respiratory Health Outcomes in the First 2 Years of Life: Effect Modification by Maternal Pre-Pregnancy BMI
Int. J. Environ. Res. Public Health 2018, 15(5), 996; https://doi.org/10.3390/ijerph15050996
Received: 18 April 2018 / Revised: 11 May 2018 / Accepted: 12 May 2018 / Published: 15 May 2018
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Abstract
Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modifier. We investigated whether maternal pre-pregnancy BMI modified the association of trimester-specific air pollution divided into [...] Read more.
Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modifier. We investigated whether maternal pre-pregnancy BMI modified the association of trimester-specific air pollution divided into quartiles of exposure (Q1–4) on respiratory health in the Growing Up in Singapore towards healthy Outcomes (GUSTO) study (n = 953) in 2-year-old children. For episodes of wheezing, children of overweight/obese mothers and who were exposed to particulate matter less than 2.5 μm (PM2.5) in the first trimester had an adjusted incidence rate ratio (IRR) (95% confidence interval (CI)) of 1.85 (1.23–2.78), 1.76 (1.08–2.85) and 1.90 (1.10–3.27) in quartile (Q) 2–4, with reference to Q1. This association is seen in the second trimester for bronchiolitis/bronchitis. The risk of ear infection in the first year of life was associated with exposure to PM2.5 in the first trimester with adjusted Odds Ratio (adjOR) (95% CI) = 7.64 (1.18–49.37), 11.37 (1.47–87.97) and 8.26 (1.13–60.29) for Q2–4, and similarly in the second year with adjOR (95% CI) = 3.28 (1.00–10.73) and 4.15 (1.05–16.36) for Q2–3. Prenatal exposure to air pollution has an enhanced impact on childhood respiratory health, and differs according to maternal pre-pregnancy BMI. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Open AccessArticle
Determinants and Temporal Trends of Perfluoroalkyl Substances in Pregnant Women: The Hokkaido Study on Environment and Children’s Health
Int. J. Environ. Res. Public Health 2018, 15(5), 989; https://doi.org/10.3390/ijerph15050989
Received: 17 April 2018 / Revised: 10 May 2018 / Accepted: 11 May 2018 / Published: 14 May 2018
Cited by 1 | PDF Full-text (701 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Perfluoroalkyl substances (PFAS) are persistent bio-accumulative chemicals that impact the health of pregnant women and their children. PFAS derive from environmental and consumer products, which depend on human lifestyle, socioeconomic characteristics, and time variation. Here, we aimed to explore the temporal trends of [...] Read more.
Perfluoroalkyl substances (PFAS) are persistent bio-accumulative chemicals that impact the health of pregnant women and their children. PFAS derive from environmental and consumer products, which depend on human lifestyle, socioeconomic characteristics, and time variation. Here, we aimed to explore the temporal trends of PFAS in pregnant women and the characteristics related to maternal PFAS concentration. Our study is part of the Hokkaido Study on Environment and Children’s Health, the Hokkaido large-scale cohort that recruited pregnant women between 2003 and 2011. Blood samples were acquired from pregnant women during the third trimester to measure PFAS and cotinine concentrations. Maternal basic information was collected with a baseline structured questionnaire. Eleven PFAS were measured from 2123 samples with ultra-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry. Eight PFAS were above 80% detection rate and were included in the final analysis. We used multivariable linear regression to analyze the association of pregnant women characteristics with the levels of eight PFAS. The temporal trend of PFAS was observed in two periods (August 2003 to January 2006 and February 2006 to July 2012). The concentration of perfluorooctane sulfonate (PFOS) significantly decreased from August 2003 to January 2006 and from February 2006 to July 2012. The concentrations of perfluorododecanoic acid (PFDoDA), perfluoroundecanoic acid (PFUnDA), and perfluorotridecanoic acid (PFTrDA) increased significantly between August 2003 and January 2006, whereas they decreased significantly between February 2006 and July 2012. Women with pre-pregnancy body mass index (BMI) >25 kg/m2 had lower PFUnDA, PFDoDA, and PFTrDA levels than did those with normal BMI (18.5–24.9 kg/m2). Pregnant women, who were active smokers (cotinine > 11.49 ng/mL), had higher PFOS than the non-smokers (cotinine < 0.22 ng/mL). Lower levels of PFHxS, PFOS, PFOA, PFNA, and PFDA were observed in women, who had given birth to more than one child. There were also significant positive associations between PFAS levels and annual income or maternal education. PFAS levels varied in women with higher pre-pregnancy BMI, active smoking status, higher education level and annual income. The causes of the individual PFAS differences should be explored in an independent study. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Decision Tree Approach to the Impact of Parents’ Oral Health on Dental Caries Experience in Children: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2018, 15(4), 692; https://doi.org/10.3390/ijerph15040692
Received: 21 March 2018 / Revised: 21 March 2018 / Accepted: 3 April 2018 / Published: 6 April 2018
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Abstract
Decision tree (DT) analysis was applied in this cross-sectional study to investigate caries experience in children by using clinical and microbiological data obtained from parent–child pairs. Thirty pairs of parents and children were recruited from periodontal and pediatric dental clinics. All participants were [...] Read more.
Decision tree (DT) analysis was applied in this cross-sectional study to investigate caries experience in children by using clinical and microbiological data obtained from parent–child pairs. Thirty pairs of parents and children were recruited from periodontal and pediatric dental clinics. All participants were clinically examined for caries and periodontitis by a calibrated examiner. Cariogenic and periodontopathic bacteria examinations were conducted. The Kendall rank correlation coefficient was used to measure the association between data variables obtained through clinical and microbiological examinations. A classificatory inductive decision tree was generated using the C4.5 algorithm with the top-down approach. The C4.5 DT analysis was applied to classify major influential factors for children dental caries experience. The DT identified parents’ periodontal health classification, decayed, missing, filled permanent teeth (DMFT) index, periodontopathic test (PerioCheck) result, and periodontal pocket depth as the classification factors for children caries experience. 13.3% of children were identified with a low decayed, missing, filled primary teeth (dmft) index (dmft < 3) whose parents had a periodontal pocket depth ≤3.7, PerioCheck score >1, DMFT index <13.5, and periodontal classification >2. The DT model for this study sample had an accuracy of 93.33%. Here, parental periodontal status and parents’ DMFT were the factors forming the DT for children’s caries experience. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Children and Caregivers’ Exposure to Adverse Childhood Experiences (ACES): Association with Children’s and Caregivers’ Psychological Outcomes in a Therapeutic Preschool Program
Int. J. Environ. Res. Public Health 2018, 15(4), 646; https://doi.org/10.3390/ijerph15040646
Received: 15 February 2018 / Revised: 15 March 2018 / Accepted: 29 March 2018 / Published: 31 March 2018
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Abstract
Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing [...] Read more.
Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver’s and the child’s exposure to ACE and multiple child and caregiver’s outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP). Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control) and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver’s exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Open AccessArticle
Different Risk Factors for Very Low Birth Weight, Term-Small-for-Gestational-Age, or Preterm Birth in Japan
Int. J. Environ. Res. Public Health 2018, 15(2), 369; https://doi.org/10.3390/ijerph15020369
Received: 22 January 2018 / Revised: 11 February 2018 / Accepted: 14 February 2018 / Published: 21 February 2018
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Abstract
From 1985 to 2013, the mean birth weight of infants in Japan decreased from 3120 g to 3000 g, and the low-birth-weight rate among live births increased from 6.3% to 9.6%. No prospective study has elucidated the risk factors for poor fetal growth [...] Read more.
From 1985 to 2013, the mean birth weight of infants in Japan decreased from 3120 g to 3000 g, and the low-birth-weight rate among live births increased from 6.3% to 9.6%. No prospective study has elucidated the risk factors for poor fetal growth and preterm birth in recent Japanese parents, such as increased parental age, maternal body figure, assisted reproductive technology (ART), and socioeconomic status. Participants were mother–infant pairs (n = 18,059) enrolled in a prospective birth cohort in Hokkaido, Japan from 2002 to 2013. Parental characteristics were obtained via self-reported questionnaires during pregnancy. Medical records helped identify very-low-birth-weight (VLBW; <1500g), term-small-for-gestational-age (term-SGA), and preterm-birth (PTB; <37 weeks) infants. We calculated relative risks (RRs) for PTB, VLBW, and term-SGA birth based on parental characteristics. The prevalence of PTB, VLBW, and term-SGA was 4.5%, 0.4%, and 6.5%, respectively. Aged parents and ART were risk factors for PTB and VLBW. Maternal alcohol drinking during pregnancy increased the risk; a parental educational level of ≥16 years reduced risk of term-SGA. Maternal pre-pregnancy BMI of <18.5 kg/m2 increased the risk of PTB and term-SGA. The RR for low BMI was highest among mothers who have low educational level. Among various factors, appropriate nutritional education to maintain normal BMI is important to prevent PTB and term-SGA in Japan. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Examining the Impact of Maternal Individual Features on Children’s Behavioral Problems in Adoptive Families: The Role of Maternal Temperament and Neurobiological Markers
Int. J. Environ. Res. Public Health 2018, 15(2), 196; https://doi.org/10.3390/ijerph15020196
Received: 3 January 2018 / Revised: 21 January 2018 / Accepted: 22 January 2018 / Published: 24 January 2018
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Abstract
The first year after adoption constitutes a sensitive period for both strengthening the new emotional bond in the family and checking its appropriate development by adoption services. A key variable for children’s catch-up are adoptive parents’ socioemotional and individual features. The aim of [...] Read more.
The first year after adoption constitutes a sensitive period for both strengthening the new emotional bond in the family and checking its appropriate development by adoption services. A key variable for children’s catch-up are adoptive parents’ socioemotional and individual features. The aim of this study is to investigate links between adoptive mothers’ individual features and behavioral problems in their children in the first year after adoption placement, by testing the moderating role of both age at adoption and maternal genetic polymorphisms. Seventy-eight adoptive mothers completed temperament and genetic measures. Mothers showed a specific pattern of interaction between basic temperament traits and genetic markers in their assessment of children’s behavioral problems; dopamine D4 receptor gene and children’s age at adoption are two moderators in the association in which mothers’ temperament was affecting the evaluation of their children’s behavioral problems. Findings highlight a still undervalued area of parenting resources in the process of post-institutionalized children’s catch-up after adoption placement, by showing how individual features count in the commonly measured variable of children’s behavioral and emotional problems. This could help in orienting identification and choice of key variables for family assessment after adoption placement, thus contributing in fostering children’s healthy development. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessFeature PaperArticle
Association between Fetal Adipokines and Child Behavioral Problems at Preschool Age: The Hokkaido Study on Environment and Children’s Health
Int. J. Environ. Res. Public Health 2018, 15(1), 120; https://doi.org/10.3390/ijerph15010120
Received: 12 October 2017 / Revised: 20 December 2017 / Accepted: 9 January 2018 / Published: 11 January 2018
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Abstract
Studies have suggested associations between maternal obesity and mental health problems of their children. However, the underlying mechanism is largely unknown. A possible mechanism can be via inflammatory states and the other possible mechanism is metabolic hormone-induced programming. Cross-talk between adipokines, including inflammatory [...] Read more.
Studies have suggested associations between maternal obesity and mental health problems of their children. However, the underlying mechanism is largely unknown. A possible mechanism can be via inflammatory states and the other possible mechanism is metabolic hormone-induced programming. Cross-talk between adipokines, including inflammatory cytokines and metabolic hormones secreted from adipose tissue and the central nervous system needs to be further investigated to elucidate the mechanism. Thus, the aim of this study was to investigate the association between fetal adipokine levels and child behavioral problems at preschool age. Cord blood adiponectin, leptin, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) levels were measured and child behavioral problems were assessed using the Strengths and Difficulties Questionnaire at preschool age. Logistic regression models adjusted by related maternal factors were performed to examine the association between cord blood adipokines and child behavioral problems. Three hundred and sixty-one children were included in the final analysis. A significant association between decreased hyperactivity/inattention and increased leptin was found (OR = 0.22, 95% CI: 0.06–0.89). Cord blood adiponectin, TNF-α and IL-6 levels were not associated with child behavioral problems. Our findings suggested that cord blood adipokines, particularly, leptin level, may be a predictor of hyperactivity/inattention problems at preschool age. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessFeature PaperArticle
Preventive Effect of Residential Green Space on Infantile Atopic Dermatitis Associated with Prenatal Air Pollution Exposure
Int. J. Environ. Res. Public Health 2018, 15(1), 102; https://doi.org/10.3390/ijerph15010102
Received: 3 December 2017 / Revised: 28 December 2017 / Accepted: 3 January 2018 / Published: 9 January 2018
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Abstract
Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether [...] Read more.
Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether exposure to nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter of <10 μm (PM10) during pregnancy is associated with increased risk of development of AD in 6-month-old children and also to examine how this association changes with residential green space. This study used prospective data from 659 participants of the Mothers and Children’s Environmental Health study. Subjects were geocoded to their residential addresses and matched with air pollution data modeled using land-use regression. Information on infantile AD was obtained by using a questionnaire administered to the parents or guardians of the children. The association between infantile AD and exposure to NO2 and PM10 was determined using logistic regression models. We assessed the effects of residential green spaces using stratified analyses and by entering product terms into the logistic regression models. The risk of infantile AD significantly increased with an increase in air pollution exposure during the first trimester of pregnancy. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.219 (1.023–1.452) per 10 μg/m3 increase in PM10 and 1.353 (1.027–1.782) per 10 ppb increase in NO2. An increase in the green space within 200 m of residence was associated with a decreased risk of AD (OR = 0.996, 95% CI: 0.993–0.999). The stratified analysis of residential green space revealed stronger associations between infantile AD and PM10 and NO2 exposure during the first trimester in the areas in the lower tertiles of green space. This study indicated that exposure to TRAP during the first trimester of pregnancy is associated with infantile AD. Less residential green space may intensify the association between TRAP exposure and infantile AD. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States
Int. J. Environ. Res. Public Health 2018, 15(1), 83; https://doi.org/10.3390/ijerph15010083
Received: 31 October 2017 / Revised: 3 January 2018 / Accepted: 3 January 2018 / Published: 6 January 2018
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Abstract
Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the [...] Read more.
Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the effect of a ban enacted in the southeastern U.S. on pregnant women’s cotinine levels. Additional analyses compared self-reported exposure to cotinine and identified characteristics associated with passive exposure. Pregnant women (N = 851) were recruited prospectively between 2005 and 2011 in North Carolina. Sociodemographic and health data were collected via surveys; maternal blood samples were assayed for cotinine. Among non-active smokers who provided self-report data regarding passive exposure (N = 503), 20% were inconsistent with corresponding cotinine. Among all non-smokers (N = 668), being unmarried, African American, and less educated were each associated with greater passive exposure. Controlling for covariates, mean cotinine was higher prior to the ban compared to after, F(1, 640) = 24.65, p < 0.001. Results suggest that banning smoking in public spaces may reduce passive smoke exposure for non-smoking pregnant women. These data are some of the first to examine the impact of legislation on passive smoke exposure in pregnant women within the U.S. using a biomarker and can inform policy in regions lacking comprehensive smoke-free legislation. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Development and Validation of the Brief Folate-Specific Food Frequency Questionnaire for Young Women’s Diet Assessment
Int. J. Environ. Res. Public Health 2017, 14(12), 1574; https://doi.org/10.3390/ijerph14121574
Received: 13 October 2017 / Revised: 5 December 2017 / Accepted: 7 December 2017 / Published: 14 December 2017
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Abstract
The tools enabling brief assessment of folate intake may be of great value for public health purposes. The aim of the presented study was to design a brief folate-specific food frequency questionnaire for Central and Eastern European population of women, as well as [...] Read more.
The tools enabling brief assessment of folate intake may be of great value for public health purposes. The aim of the presented study was to design a brief folate-specific food frequency questionnaire for Central and Eastern European population of women, as well as to assess the validity and reproducibility of the designed Folate-Intake Calculation-Food Frequency Questionnaire (Fol-IC-FFQ) on a group of Polish women aged 20–30 years. Participants collected 3-day dietary records and completed the Fol-IC-FFQ twice (FFQ1: directly after the dietary record; and FFQ2: six weeks later). The analysis included an assessment of validity (comparison of the results of FFQ1 and 3-day dietary record) and of reproducibility (comparison of the results of FFQ1 and FFQ2). In assessment of validity, a Bland-Altman index of 5.3% was observed. In assessment of reproducibility, a Bland-Altman index of 2.7% was observed, the share of individuals classified into the same intake adequacy category was over 85%, the share of individuals classified into the same tertile was almost 75%, the weighted κ statistic indicated substantial agreement (0.67) and correlation was significant (p = 0.0000; R = 0.7995). Assessment of the Fol-IC-FFQ revealed a satisfactory level of validity and very good level of reproducibility in the population of young Polish women. The Fol-IC-FFQ may be considered a valid tool for the assessment of folate intake in young Polish women and a promising tool for the assessment of folate intake in young women in Central and Eastern Europe. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Patient–Provider Communication and Counseling about Gestational Weight Gain and Physical Activity: A Qualitative Study of the Perceptions and Experiences of Latinas Pregnant with their First Child
Int. J. Environ. Res. Public Health 2017, 14(11), 1412; https://doi.org/10.3390/ijerph14111412
Received: 3 October 2017 / Revised: 9 November 2017 / Accepted: 14 November 2017 / Published: 18 November 2017
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Abstract
Latina women in the United States (U.S.) are disproportionately affected by obesity and are more likely to begin pregnancy overweight and gain excessive weight during pregnancy. The prenatal care period represents a window of opportunity for women to access the healthcare system and [...] Read more.
Latina women in the United States (U.S.) are disproportionately affected by obesity and are more likely to begin pregnancy overweight and gain excessive weight during pregnancy. The prenatal care period represents a window of opportunity for women to access the healthcare system and receive preventive services, education, nutritional support, and other social services to improve pregnancy outcomes. Excessive gestational weight gain (GWG) has numerous negative short- and long-term consequences for both the mother and newborn. We explored nulliparous Latina women’s perceptions about their experiences communicating with their primary healthcare provider about GWG and physical activity (PA) to identify possible intervention targets using in-depth, semi-structured interviews. Bilingual, trained research staff conducted 23 interviews with first-time pregnant Latinas between 22 and 36 weeks of gestation. Interviews were transcribed verbatim and analyzed using content analysis. Salient text passages were extracted, shortened, coded, and grouped into categories. Women, including those who self-identified as being overweight or obese prior to pregnancy, reported receiving limited or no advice from their healthcare providers about GWG or PA. Additionally, analysis revealed that although participants value information received from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program counselors, they would like to receive more information from their primary healthcare providers about adequate GWG. Furthermore, study findings indicate that some participants received conflicting information regarding PA during pregnancy. Study findings suggest the need for increased integration of communication and counseling about GWG and PA into prenatal care services to promote healthy weight gain and PA among low-income Latina women. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Open AccessArticle
Sleep and Dietary Patterns in Pregnancy: Findings from the GUSTO Cohort
Int. J. Environ. Res. Public Health 2017, 14(11), 1409; https://doi.org/10.3390/ijerph14111409
Received: 5 September 2017 / Revised: 3 November 2017 / Accepted: 15 November 2017 / Published: 17 November 2017
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Abstract
Evidence on the association between sleep, diet, and eating behaviors in pregnant women is lacking. We examine this in a cohort of apparently healthy pregnant women. At 26–28 weeks gestation, 497 participants completed the Pittsburgh Sleep Quality Index to assess sleep and a [...] Read more.
Evidence on the association between sleep, diet, and eating behaviors in pregnant women is lacking. We examine this in a cohort of apparently healthy pregnant women. At 26–28 weeks gestation, 497 participants completed the Pittsburgh Sleep Quality Index to assess sleep and a 24-h recall to assess dietary intake. Diet quality was assessed by the Healthy Eating Index for pregnant women in Singapore (HEI-SGP) score and previously derived dietary patterns (vegetables-fruit-rice, seafood-noodles, and pasta-cheese-meat pattern). Eating behaviors studied included the longest night-time fasting interval, frequency of consumption occasions, energy from discretionary foods, and nighttime eating. Adjusted means were estimated between poor/good quality and short/normal sleepers using linear regressions, including covariates. Good sleep quality versus poor sleep quality, was associated with better diet quality (mean HEI-SGP 54.6 vs. 52.0; p = 0.032), greater adherence to the vegetables-fruit-rice pattern (mean 0.03 vs. −0.15; p = 0.039), lesser adherence to the seafood-noodle pattern (mean −0.14 vs. 0.03; p = 0.024), and a trending lower calories from discretionary foods (mean 330.5 vs. 382.6 kcal; p = 0.073), after adjusting for covariates. After additional adjustment for anxiety, only sleep quality and the seafood-noodle pattern remained significantly associated (p = 0.018). Short sleep was not associated with any diet or eating behavior. In conclusion, good sleep quality is associated with a better diet quality and a greater adherence to the vegetable-fruit-rice pattern, but with lesser adherence to the seafood-noodle diets in pregnant women. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle
Vitamin D Concentration in Maternal and Umbilical Cord Blood by Season
Int. J. Environ. Res. Public Health 2017, 14(10), 1121; https://doi.org/10.3390/ijerph14101121
Received: 11 August 2017 / Revised: 21 September 2017 / Accepted: 22 September 2017 / Published: 26 September 2017
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Abstract
Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland—winter and [...] Read more.
Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland—winter and summer. A total of 100 pregnant women with no history of chronic diseases before pregnancy were included in the study. Pre-delivery maternal venous blood and neonatal cord blood samples were collected and total 25(OH)D concentration was measured. Data on vitamin D consumption (collected with the use of Food Frequency Questionnaire) and lifestyle factors were taken. Both, maternal and umbilical cord blood concentrations of vitamin D were higher in the summer group as compared to the winter group (mean 22.2 ± 6.5 ng/mL vs. 16.5 ± 8.2 ng/mL (p < 0.001), respectively for the mothers and 31.3 ± 9.4 ng/mL vs. 22.7 ± 11.0 ng/mL (p < 0.0001), respectively for the neonates). However, only 16% of the pregnant women reached the optimal vitamin D concentration during summer. Therefore, summer improves the levels of vitamin D in the body but does not guarantee the recommended concentration and supplementation throughout the whole year is essential. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Review

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Open AccessReview
Non-Traditional Risk Factors of Albuminuria in the Pediatric Population: A Scoping Review
Int. J. Environ. Res. Public Health 2017, 14(10), 1231; https://doi.org/10.3390/ijerph14101231
Received: 22 July 2017 / Revised: 11 October 2017 / Accepted: 11 October 2017 / Published: 16 October 2017
Cited by 1 | PDF Full-text (323 KB) | HTML Full-text | XML Full-text
Abstract
The presence of albumin in urine has been used for more than four decades as a marker of renal and cardiovascular damage. Most of the information on this marker is related to adults. The prevalence of albuminuria in the pediatric population has been [...] Read more.
The presence of albumin in urine has been used for more than four decades as a marker of renal and cardiovascular damage. Most of the information on this marker is related to adults. The prevalence of albuminuria in the pediatric population has been reported as being 2.2–12.8% in some countries. Most research in this field is related to albuminuria and diseases, such as diabetes and hypertension. Using the methodology described by Arksey and O’Malley in 2005, a scoping review was carried out to show that the presence of albumin in urine in the pediatric population might be associated with environmental, demographic, congenital, infectious, and non-infectious factors. The information collected is supported by 74 references present in PubMed. The results reveal the multiple causes associated with albuminuria in the pediatric population. This information can be very useful for clinical practice by adding knowledge about albuminuria behavior in children. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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