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Special Issue "Environmental Influences on Maternal and Child Health"

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 2017)

Special Issue Editors

Guest Editor
Prof. Dr. Katherine P. Theall

Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University Health Sciences Center, 1440 Canal St., Mailcode 8319, New Orleans, LA 70112, USA
Website | E-Mail
Guest Editor
Prof. Dr. Carolyn C. Johnson

Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Ste 2210, #8319, New Orleans, LA 70112, USA
Website | E-Mail
Interests: public health; obesity; nutrition; physical activity; the built environment; smoking; sexual behavior; and process evaluation

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on the impact of the environment 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 about the journal, we refer you to https://www.mdpi.com/journal/ijerph. 

Both maternal and child morbidity and mortality are significant problems worldwide. Maternal and child health encompasses health status and well-being of women, infants, children, adolescents, and their families. Their well-being determines the health of the next generation, and can help predict future public health challenges for families, communities, and the healthcare system. Stark racial, ethnic, and socioeconomic disparities in mortality and morbidity for mothers and children are evident worldwide. These differences are likely the result of many factors which are influenced by a variety of environmental and social issues, such as environmental exposures, access to healthcare, and chronic stress. Research, both in cities and rural areas, and in both developing and developed countries, can offer a critical guide for policy efforts and planning for public health. This Special Issue aims to highlight problems and solutions to environmental influences on maternal and child health, in both high- and low-resource settings. 

This Special Issue is open to any subject area related to the impacts of the chemical, natural, built, and social environments on maternal and child health. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Katherine P. Theall
Prof. Dr. Carolyn C. Johnson
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 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

  • Life course and development
  • Health inequity and inequality
  • Community-based research and practice
  • Chemical environments
  • Built environments
  • Social environments, including household/family and community
  • Social justice
  • Violence and conflict
  • Environmental justice
  • Interdisciplinary and multilevel approaches
  • Access to preventive and child care services
  • Coordinated care
  • Children with special healthcare needs
  • Adverse childhood experiences

Published Papers (19 papers)

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Editorial

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Open AccessEditorial Environmental Influences on Maternal and Child Health
Int. J. Environ. Res. Public Health 2017, 14(9), 1088; https://doi.org/10.3390/ijerph14091088
Received: 13 September 2017 / Revised: 13 September 2017 / Accepted: 15 September 2017 / Published: 20 September 2017
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Abstract
This Special Issue of IJERPH focuses on maternal and child health (MCH), with research that highlights the role of environmental influences on MCH across a range of settings.[...] Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)

Research

Jump to: Editorial, Other

Open AccessArticle Family Social Environment and Parenting Predictors of Alcohol Use among Adolescents in Lithuania
Int. J. Environ. Res. Public Health 2017, 14(9), 1037; https://doi.org/10.3390/ijerph14091037
Received: 3 July 2017 / Revised: 17 August 2017 / Accepted: 25 August 2017 / Published: 8 September 2017
Cited by 2 | PDF Full-text (299 KB) | HTML Full-text | XML Full-text
Abstract
The role of the family as the social environment in shaping adolescent lifestyle has recently received substantial attention. This study was focused on investigating the association between familial and parenting predictors and alcohol use in school-aged children. Adolescents aged 13- and 15-year from [...] Read more.
The role of the family as the social environment in shaping adolescent lifestyle has recently received substantial attention. This study was focused on investigating the association between familial and parenting predictors and alcohol use in school-aged children. Adolescents aged 13- and 15-year from a representative sample (N = 3715) of schools in Lithuania were surveyed during the spring of 2014. The methodology of the cross-national Health Behaviour in School-aged Children (HBSC) study was applied. HBSC international questionnaires were completed in the classroom anonymously for obtaining information about drinking of alcoholic beverages and family characteristics—family’s affluence and structure, style of communication in the family, parenting style, parental monitoring, family time together, etc. Univariate and multivariate logistic regression analysis was applied for assessment of the association between familial variables and weekly alcohol use. Analysis has demonstrated that adolescents from non-intact families tended to show significantly higher risk of being weekly drinkers (OR = 1.69; 95% CI: 1.30–2.19). The following parenting factors were associated with weekly use of alcohol: father’s and mother’s low monitoring, father’s authoritarian-repressive and mother’s permissive-neglectful parenting style. Frequent family time together and frequent electronic media communication with parents showed an inverse negative effect than was predicted. The study suggests that alcohol misuse among adolescents could be associated with a non-intact family structure as well as with complex family and parenting determinants which should be investigated more thoroughly by further studies. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Environmental Tobacco Smoke Exposure during Pregnancy and Child Neurodevelopment
Int. J. Environ. Res. Public Health 2017, 14(7), 796; https://doi.org/10.3390/ijerph14070796
Received: 29 April 2017 / Revised: 6 July 2017 / Accepted: 9 July 2017 / Published: 17 July 2017
Cited by 7 | PDF Full-text (325 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The developing fetus is especially vulnerable to environmental toxicants, including tobacco constituents. The aim of this study was to assess the impact of environmental tobacco smoke (ETS) exposure during pregnancy on child neurodevelopment within the first two years of life. The study population [...] Read more.
The developing fetus is especially vulnerable to environmental toxicants, including tobacco constituents. The aim of this study was to assess the impact of environmental tobacco smoke (ETS) exposure during pregnancy on child neurodevelopment within the first two years of life. The study population consisted of 461 non-smoking pregnant women (saliva cotinine level <10 ng/mL). Maternal passive smoking was assessed based on the cotinine level in saliva analyzed by the use of high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS) and by questionnaire data. The cotinine cut-off value for passive smoking was established at 1.5 ng/mL (sensitivity 63%, specificity 71%). Psychomotor development was assessed in children at the age of one- and two-years using the Bayley Scales of Infant and Toddler Development. Approximately 30% of the women were exposed to ETS during pregnancy. The multivariate linear regression model indicated that ETS exposure in the 1st and the 2nd trimesters of pregnancy were associated with decreasing child language functions at the age of one (β = −3.0, p = 0.03, and β = −4.1, p = 0.008, respectively), and two years (β = −3.8, p = 0.05, and β = −6.3, p = 0.005, respectively). A negative association was found for cotinine level ≥1.5 ng/mL in the 2nd trimester of pregnancy and child cognition at the age of 2 (β = −4.6, p = 0.05), as well as cotinine levels ≥1.5 ng/mL in all trimesters of pregnancy and child motor abilities at two years of age (β = −3.9, p = 0.06, β = −5.3, p = 0.02, and β = −4.2, p = 0.05, for the 1st, the 2nd, and the 3rd trimester of pregnancy, respectively; for the 1st trimester the effect was of borderline statistical significance). This study confirmed that ETS exposure during pregnancy can have a negative impact on child psychomotor development within the first two years of life and underscore the importance of public health interventions aiming at reducing this exposure. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Correlations of Biomarkers and Self-Reported Seafood Consumption among Pregnant and Non-Pregnant Women in Southeastern Louisiana after the Gulf Oil Spill: The GROWH Study
Int. J. Environ. Res. Public Health 2017, 14(7), 784; https://doi.org/10.3390/ijerph14070784
Received: 30 April 2017 / Revised: 7 July 2017 / Accepted: 10 July 2017 / Published: 14 July 2017
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Abstract
Seafood contains health-promoting fatty acids, but is often contaminated with mercury (Hg), complicating recommendations and choices around fish consumption during pregnancy. Self-reported diet may be subject to inaccuracy and this inaccuracy could differ according to pregnancy status. We investigated correlations between self-reported seafood [...] Read more.
Seafood contains health-promoting fatty acids, but is often contaminated with mercury (Hg), complicating recommendations and choices around fish consumption during pregnancy. Self-reported diet may be subject to inaccuracy and this inaccuracy could differ according to pregnancy status. We investigated correlations between self-reported seafood consumption and blood levels of Hg and n-3 polyunsaturated fatty acids (PUFAs) in women affected by the Deepwater Horizon oil spill. Spearman correlation coefficients were calculated comparing log blood Hg and n-3 PUFAs to seafood consumption, then stratified by pregnancy status. Crude and adjusted linear regression models were constructed using biomarkers of Hg and n-3 PUFA and seafood consumption, adjusting for age and pregnancy status. Weak but significant correlations were found between log Hg levels and intake of Hg-containing seafood ( r = 0.15) and were slightly stronger among pregnant women ( r = 0.22, vs. r = 0.10). Biomarkers for n-3 PUFAs were significantly correlated with seafood consumption ( r = 0.12). Hg-containing seafood consumption was associated with increased blood level Hg in the highest quartile in both unadjusted (β = 0.34, 95% CI: 0.15–0.53) and adjusted models (β = 0.28, 95% CI: 0.08–0.48). Self-reported seafood consumption was correlated with biomarkers of both n-3 PUFA and Hg, but this association was different when stratified by pregnancy status. Pregnant women may have better recall of Hg-containing seafood compared to nonpregnant women. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Chronic and Acute Ozone Exposure in the Week Prior to Delivery Is Associated with the Risk of Stillbirth
Int. J. Environ. Res. Public Health 2017, 14(7), 731; https://doi.org/10.3390/ijerph14070731
Received: 12 May 2017 / Revised: 26 June 2017 / Accepted: 29 June 2017 / Published: 6 July 2017
Cited by 4 | PDF Full-text (313 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Chronic and acute air pollution has been studied in relation to stillbirth with inconsistent findings. We examined stillbirth risk in a retrospective cohort of 223,375 singleton deliveries from 12 clinical sites across the United States. Average criteria air pollutant exposure was calculated using [...] Read more.
Chronic and acute air pollution has been studied in relation to stillbirth with inconsistent findings. We examined stillbirth risk in a retrospective cohort of 223,375 singleton deliveries from 12 clinical sites across the United States. Average criteria air pollutant exposure was calculated using modified Community Multiscale Air Quality models for the day of delivery and each of the seven days prior, whole pregnancy, and first trimester. Poisson regression models using generalized estimating equations estimated the relative risk (RR) of stillbirth and 95% confidence intervals (CI) in relation to an interquartile range increase in pollutant with adjustment for temperature, clinical, and demographic factors. Ozone (O3) was associated with a 13–22% increased risk of stillbirth on days 2, 3, and 5–7 prior to delivery in single pollutant models, and these findings persisted in multi-pollutant models for days 5 (RR = 1.22, CI = 1.07–1.38) and 6 (RR = 1.18, CI = 1.04–1.33). Whole pregnancy and first trimester O3 increased risk 18–39% in single pollutant models. Maternal asthma increased stillbirth risk associated with chronic PM2.5 and carbon monoxide exposures. Both chronic and acute O3 exposure consistently increased stillbirth risk, while the role of other pollutants varied. Approximately 8000 stillbirths per year in the US may be attributable to O3 exposure. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Self-Reported Oil Spill Exposure and Pregnancy Complications: The GROWH Study
Int. J. Environ. Res. Public Health 2017, 14(7), 692; https://doi.org/10.3390/ijerph14070692
Received: 29 May 2017 / Revised: 15 June 2017 / Accepted: 22 June 2017 / Published: 27 June 2017
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Abstract
Adverse infant outcomes often rise in the aftermath of disaster, but few studies have assessed the effects of disaster on maternal health. 1091 southern Louisiana women were interviewed about their pregnancy history, including pregnancy complications. Associations between oil spill exposures and gestational diabetes, [...] Read more.
Adverse infant outcomes often rise in the aftermath of disaster, but few studies have assessed the effects of disaster on maternal health. 1091 southern Louisiana women were interviewed about their pregnancy history, including pregnancy complications. Associations between oil spill exposures and gestational diabetes, hypertensive disorders, and nausea/vomiting were assessed for all reported pregnancies. 631 women had a pregnancy both before and after the oil spill. Generalized estimating equations (logistic regression) with adjustment for confounders were used. To assess possible unmeasured confounding, instead of considering oil spill exposure as a time-varying exposure, women were defined as oil spill-exposed or not. If oil spill-exposed women were equally prone to complications in pregnancies that occurred prior to the oil spill as after it, it was considered that any associations were likely due to selection or reporting issues. Women who reported oil spill exposure, particularly loss of use of the coast, were more likely to report gestational diabetes; however, the level of association was similar for pregnancies before and after the spill (p for interaction >0.10 and odds ratios (ORs) for pregnancies prior to the spill > than those after the spill). No associations were found between oil spill exposure and hypertensive disorders. This analysis does not suggest an increased risk of pregnancy complications associated with exposure to the oil spill; however, future studies should assess exposure and outcomes prospectively and clinically instead of relying on self-report. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Beyond Food Access: The Impact of Parent-, Home-, and Neighborhood-Level Factors on Children’s Diets
Int. J. Environ. Res. Public Health 2017, 14(6), 662; https://doi.org/10.3390/ijerph14060662
Received: 5 May 2017 / Revised: 3 June 2017 / Accepted: 13 June 2017 / Published: 20 June 2017
Cited by 3 | PDF Full-text (293 KB) | HTML Full-text | XML Full-text
Abstract
Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis [...] Read more.
Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis utilized data from a community-based, cross-sectional sample of children (n = 199) that was collected in New Orleans, Louisiana, in 2010. This dataset was linked to food environment data to assess the impact of neighborhood food access as well as household and parent factors on children’s diets. We observed a negligible impact of the neighborhood food environment on children’s diets, except with respect to fast food, with children who had access to fast food within 500 m around their home significantly less likely (OR = 0.35, 95% CI: 0.1, 0.8) to consume vegetables. Key parental and household factors did play a role in diet, including receipt of public assistance and cooking meals at home. Children receiving public assistance were 2.5 times (95% CI: 1.1, 5.4) more likely to consume fruit more than twice per day compared with children not receiving public assistance. Children whose family cooked dinner at home more than 5 times per week had significantly more consumption of fruit (64% vs. 58%) and vegetables (55% vs. 39%), but less soda (27% vs. 43%). Findings highlight the need for future research that focuses on the dynamic and complex relationships between built and social factors in the communities and homes of children that impact their diet in order to develop multilevel prevention approaches that address childhood obesity. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Environmental Barriers to Participation of Preschool Children with and without Physical Disabilities
Int. J. Environ. Res. Public Health 2017, 14(5), 518; https://doi.org/10.3390/ijerph14050518
Received: 17 February 2017 / Revised: 28 April 2017 / Accepted: 6 May 2017 / Published: 11 May 2017
Cited by 2 | PDF Full-text (1038 KB) | HTML Full-text | XML Full-text
Abstract
Environment plays a vital role in affecting participation of young children in home, school, and community. Knowledge of environmental barriers helps to develop solutions or strategies that enable participation. The study compared the environmental barriers perceived by parents of preschool children with physical [...] Read more.
Environment plays a vital role in affecting participation of young children in home, school, and community. Knowledge of environmental barriers helps to develop solutions or strategies that enable participation. The study compared the environmental barriers perceived by parents of preschool children with physical disabilities (PD, n = 142) and with typical development (TD, n = 192) in Taiwan. Parents identified environmental barriers by structured interview using the Chinese version of the Child and Adolescent Scale of Environment (CASE-C). The CASE-C is an 18-item measure of the impact of problems with physical, social, and attitudinal environmental features. Differences between the PD and TD groups in the summary scores for the CASE-C and the percentages of parents who perceived a problem for each item were examined by the analysis of covariance (ANCOVA) and Chi-square test. Parents of children with PD more often identified barriers related to family resources and community programs or services, social attitudes, assistance and supports outside of home, physical design of home and community, transportation, and assistive devices or equipment. Greater impacts of barriers were also reported by parents of preschool children with PD. Our findings provide evidence of environmental barriers that inform practice and policies to modify the barriers and provide an accessible and inclusive environment for families with young children. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Open AccessArticle Lunch Salad Bars in New Orleans’ Middle and High Schools: Student Intake of Fruit and Vegetables
Int. J. Environ. Res. Public Health 2017, 14(4), 415; https://doi.org/10.3390/ijerph14040415
Received: 3 March 2017 / Revised: 10 April 2017 / Accepted: 12 April 2017 / Published: 13 April 2017
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Abstract
The school lunch salad bar (SB) is a recommended food environmental strategy to increase access to, and consumption of fruit and vegetables (F/V). In a study to examine use of school lunch SBs, middle and high school students provided data via the Automated [...] Read more.
The school lunch salad bar (SB) is a recommended food environmental strategy to increase access to, and consumption of fruit and vegetables (F/V). In a study to examine use of school lunch SBs, middle and high school students provided data via the Automated Self-Administered 24-h dietary recall (24HDR) tool for kids (ASA24-Kids-2012), a web-based data collection platform. Kilocalories were computed, food groups were assigned and F/V sources were obtained. Students (n = 718) from 12 schools with SBs and nine schools without SBs were approximately 87% African American, over 64% female and most were 7th and 8th graders. SB school students had higher median energy consumption at lunch but a higher percent of non-SB students reported eating fruit at lunch compared to SB students. Most students reporting eating F/V at lunch obtained F/V from the cafeteria main line; only 19.6% reported eating F/V exclusively from the SB. In SB schools median intake of cups F/V was higher among students using the SB (0.92) compared to those not using the SB (0.53). Results of this study are mixed, but encouraging. Additional factors, e.g., nutrition education, marketing, and kinds of foods offered on the SB need to be examined for potential influence on SB use. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Open AccessArticle Lead Exposure Assessment among Pregnant Women, Newborns, and Children: Case Study from Karachi, Pakistan
Int. J. Environ. Res. Public Health 2017, 14(4), 413; https://doi.org/10.3390/ijerph14040413
Received: 20 January 2017 / Revised: 22 March 2017 / Accepted: 10 April 2017 / Published: 13 April 2017
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Abstract
Lead (Pb) in petrol has been banned in developed countries. Despite the control of Pb in petrol since 2001, high levels were reported in the blood of pregnant women and children in Pakistan. However, the identification of sources of Pb has been elusive [...] Read more.
Lead (Pb) in petrol has been banned in developed countries. Despite the control of Pb in petrol since 2001, high levels were reported in the blood of pregnant women and children in Pakistan. However, the identification of sources of Pb has been elusive due to its pervasiveness. In this study, we assessed the lead intake of pregnant women and one- to three-year-old children from food, water, house dust, respirable dust, and soil. In addition, we completed the fingerprinting of the Pb isotopic ratios (LIR) of petrol and secondary sources (food, house-dust, respirable dust, soil, surma (eye cosmetics)) of exposure within the blood of pregnant women, newborns, and children. Eight families, with high (~50 μg/dL), medium (~20 μg/dL), and low blood levels (~10 μg/dL), were selected from 60 families. The main sources of exposure to lead for children were food and house-dust, and those for pregnant women were soil, respirable dust, and food. LIR was determined by inductively coupled plasma quadrupole mass spectrometry (ICP-QMS) with a two sigma uncertainty of ±0.03%. The LIR of mothers and newborns was similar. In contrast, surma, and to a larger extent petrol, exhibited a negligible contribution to both the child’s and mother’s blood Pb. Household wet-mopping could be effective in reducing Pb exposure. This intake assessment could be replicated for other developing countries to identify sources of lead and the burden of lead exposure in the population. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Open AccessArticle Smart Device Use and Perceived Physical and Psychosocial Outcomes among Hong Kong Adolescents
Int. J. Environ. Res. Public Health 2017, 14(2), 205; https://doi.org/10.3390/ijerph14020205
Received: 27 November 2016 / Revised: 7 February 2017 / Accepted: 15 February 2017 / Published: 18 February 2017
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Abstract
Excessive electronic screen-based activities have been found to be associated with negative outcomes. The aim of this study was to investigate the prevalences and patterns of smart device activities and the purposes and perceived outcomes related to smart device use, and the differences [...] Read more.
Excessive electronic screen-based activities have been found to be associated with negative outcomes. The aim of this study was to investigate the prevalences and patterns of smart device activities and the purposes and perceived outcomes related to smart device use, and the differences in patterns of smart device activities between adolescents who did and did not perceive these outcomes. The study was a cross-sectional survey of Hong Kong primary and secondary school students. Demographic characteristics, purpose and pattern of the activities, and frequencies of the outcomes were measured. Data from 960 adolescents aged 10–19 were analyzed. Nearly 86% of the sample use smart device daily. The one-week prevalence of perceived sleep deprivation, eye discomfort, musculoskeletal discomfort, family conflict and cyberbullying victimization related to smart device use were nearly 50%, 45%, 40%, 20% and 5% respectively. More than 25% of the respondents were at risk of negative outcomes related to smart device activities for more than 1 h per day, browsing and gaming on at least 4 days per week and watching TV/movies and posting on more than 2 days per week. Their patterns of smart device activities may put a significant number of them at risk of negative outcomes. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?
Int. J. Environ. Res. Public Health 2017, 14(1), 40; https://doi.org/10.3390/ijerph14010040
Received: 3 December 2016 / Revised: 23 December 2016 / Accepted: 28 December 2016 / Published: 3 January 2017
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Abstract
Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) [...] Read more.
Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Parental Perceptions of the Social Environment Are Inversely Related to Constraint of Adolescents’ Neighborhood Physical Activity
Int. J. Environ. Res. Public Health 2016, 13(12), 1266; https://doi.org/10.3390/ijerph13121266
Received: 7 November 2016 / Revised: 12 December 2016 / Accepted: 14 December 2016 / Published: 21 December 2016
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Abstract
Background: The current study examined relationships between the neighborhood social environment (parental perceived collective efficacy (PCE)), constrained behaviors (e.g., avoidance or defensive behaviors) and adolescent offspring neighborhood physical activity in low- versus high-incivility neighborhoods. Methods: Adolescents (n = 71; 11–18 years (14.2, [...] Read more.
Background: The current study examined relationships between the neighborhood social environment (parental perceived collective efficacy (PCE)), constrained behaviors (e.g., avoidance or defensive behaviors) and adolescent offspring neighborhood physical activity in low- versus high-incivility neighborhoods. Methods: Adolescents (n = 71; 11–18 years (14.2, SD ± 1.6); male = 37 (52%); non-white = 24 (33.8%); low-income = 20 (29%); overweight/obese = 40 (56%)) and their parents/guardians enrolled in the Molecular and Social Determinants of Obesity in Developing Youth study were included in the current study. Questionnaires measured parents’/guardians’ PCE, constrained outdoor play practices and offspring neighborhood physical activity. Systematic social observation performed at the parcel-level using Google Street View assessed neighborhood incivilities. t-tests and chi-square tests determined differences by incivilities. Multilevel regression models examined relationships between PCE and: (1) constrained behaviors; and (2) neighborhood physical activity. The Hayes (2013) macro determined the mediating role of constrained behaviors. Results: Parents who had higher PCE reported lower levels of avoidance (p = 0.04) and defensive (p = 0.05) behaviors. However, demographic variables (i.e., gender, race and annual household income) limited these results. The direct relationship between PCE and parent-reported neighborhood physical activity was statistically significant in high-incivility neighborhoods only. Neither avoidance nor defensive behavior mediated the relationship between PCE and neighborhood physical activity. Conclusions: PCE influences parenting behaviors related to youth physical activity. Community-based programs that seek to facilitate social cohesion and control may be needed to increase adolescents’ physical activity. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Open AccessArticle Antenatal Dexamethasone Exposure in Preterm Infants Is Associated with Allergic Diseases and the Mental Development Index in Children
Int. J. Environ. Res. Public Health 2016, 13(12), 1206; https://doi.org/10.3390/ijerph13121206
Received: 6 October 2016 / Revised: 16 November 2016 / Accepted: 1 December 2016 / Published: 3 December 2016
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Abstract
Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to [...] Read more.
Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g. The status of antenatal exposure to steroids and allergic diseases were surveyed using a modified ISAAC questionnaire for subjects aged 2–5 years old. We analyzed Th1/Th2/Th17 expression of mRNA, cytokines (using the Magpix® my-system), and mental development index (MDI). Results: Among the 40 patients that were followed, the data showed that the antenatal dexamethasone exposure group (N = 24) had a significantly higher incidence of allergic diseases (75.0% vs. 18.8%, p < 0.0001) when compared to the non-dexamethasone exposure group (N = 16), especially with regard to asthma (41.7% vs. 0.0%, p = 0.003) and allergic rhinitis (58.3% vs. 18.8%, p = 0.013), but not atopic dermatitis. No statistical difference was observed in the mRNA expression levels of total white blood cell count between the dexamethasone exposure and non-exposure groups (p > 0.05). However, the asthma group had higher IL-5 levels (p = 0.009), and the MDI was shown to be significantly higher in the dexamethasone exposure group (90.38 ± 3.31 vs. 79.94 ± 3.58, p = 0.043) while no significant difference was found between the PDI of the two groups. Conclusions: Exposure to antenatal dexamethasone in preterm infants will increase their susceptibility to allergic diseases, particularly asthma and allergic rhinitis. Preterm infants’ exposure to antenatal dexamethasone also results in higher MDI scores. Such increases in allergic diseases may be related to increased IL-5 and IL-10 levels. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Open AccessArticle Mediation of the Physical Activity and Healthy Nutrition Behaviors of Preschool Children by Maternal Cognition in China
Int. J. Environ. Res. Public Health 2016, 13(9), 909; https://doi.org/10.3390/ijerph13090909
Received: 25 July 2016 / Revised: 23 August 2016 / Accepted: 7 September 2016 / Published: 13 September 2016
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Abstract
(1) Objective: We aimed to explore the role of social cognitive theory (SCT) of mothers in the physical activity and healthy nutrition behaviors of preschool children; (2) Methods: We used a self-administered five-point Likert common physical activity and nutrition behaviors scale in Chinese [...] Read more.
(1) Objective: We aimed to explore the role of social cognitive theory (SCT) of mothers in the physical activity and healthy nutrition behaviors of preschool children; (2) Methods: We used a self-administered five-point Likert common physical activity and nutrition behaviors scale in Chinese based on a social cognitive theory scale in English with established validity and reliability in the USA. The current study adopted the proportional sampling method to survey mothers of preschool children in four areas—namely, Chongqing, Chengdu, Taiyuan, and Shijiazhuang—of China; (3) Results: We included 1208 mothers (80.0% mothers of normal weight children, age 31.87 ± 4.19 years). Positive correlations were found between maternal social cognition and preschool children’s physical activity (PA) behavior (p < 0.0001). However, an insignificant correlation is observed between preschool children’s fruits and vegetables (FV) behavior, screen time (ST) behavior, and maternal social cognition; (4) Conclusions: This study provides some implications for increasing fruit and vegetable consumption, increasing physical activity time, and reducing screen time in preschool children using SCT in China. Maternal social cognition is associated with preschool children’s PA behavior, and the results suggest that maternal social cognition may not affect children FV and ST behaviors. Further research is necessary to test the mediation of maternal social cognition on preschool children’s ST behavior and the correlations between maternal social cognition and children’s ST behavior. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessArticle Hemoglobin Status and Externalizing Behavioral Problems in Children
Int. J. Environ. Res. Public Health 2016, 13(8), 758; https://doi.org/10.3390/ijerph13080758
Received: 16 May 2016 / Revised: 7 July 2016 / Accepted: 22 July 2016 / Published: 26 July 2016
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Abstract
Background: Still considered one of the most prevalent nutritional problems in the world, anemia has been shown in many studies to have deleterious effects on neurobehavioral development. While most research efforts have focused on investigating the effects of anemia on social and [...] Read more.
Background: Still considered one of the most prevalent nutritional problems in the world, anemia has been shown in many studies to have deleterious effects on neurobehavioral development. While most research efforts have focused on investigating the effects of anemia on social and emotional development of infants by using a cross-sectional design, research is still needed to investigate whether early childhood anemia, beyond infantile years, is linked with behavioral problems. Objective: This study assessed whether (1) hemoglobin (Hb) levels in early childhood are associated with externalizing behavior; and (2) this relationship is confounded by social adversity. Methods: Hemoglobin levels were taken from children (N = 98) of the China Jintan Cohort Study at age 4 years, and externalizing behaviors (attention and aggression) were assessed with the Child Behavior Checklist (ASEBA-CBCL) at age 6 years (mean age 5.77 ± 0.39 years old). Results: Compared with other children in the sample, children with relatively lower Hb levels at age 4 had more behavioral problems in both attention and aggression at age 6, independent of social adversity. For boys, this association was significant for attention problems, which did not interact with social adversity. For girls, the association was significant for aggression, which interacted with social adversity. While girls on average exhibited higher social adversity than boys, the main effect of Hb was only significant in girls with low social adversity. Conclusions: These results indicate that there is an inverse association between hemoglobin levels and later behavioral problems. Findings of this study suggest that regular monitoring of children’s hemoglobin levels and appropriate intervention may help with early identification of behavioral problems. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Open AccessArticle Phthalate Metabolites, Consumer Habits and Health Effects
Int. J. Environ. Res. Public Health 2016, 13(7), 717; https://doi.org/10.3390/ijerph13070717
Received: 14 May 2016 / Revised: 8 July 2016 / Accepted: 13 July 2016 / Published: 15 July 2016
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Abstract
Phthalates are multifunctional chemicals used in a wide variety of consumer products. The aim of this study was to investigate whether levels of urinary phthalate metabolites in urine samples of Austrian mothers and their children were associated with consumer habits and health indicators. [...] Read more.
Phthalates are multifunctional chemicals used in a wide variety of consumer products. The aim of this study was to investigate whether levels of urinary phthalate metabolites in urine samples of Austrian mothers and their children were associated with consumer habits and health indicators. Within an Austrian biomonitoring survey, urine samples from 50 mother-child pairs of five communities (two-stage random stratified sampling) were analysed. The concentrations of 14 phthalate metabolites were determined, and a questionnaire was administered. Monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), mono-(5-carboxy-2-ethylpentyl) phthalate (5cx-MEPP), and 3-carboxy-mono-propyl phthalate (3cx-MPP) could be quantified in the majority of samples. Significant correlations were found between the use of hair mousse, hair dye, makeup, chewing gum, polyethylene terephthalate (PET) bottles and the diethyl phthalate (DEP) metabolite MEP. With regard to health effects, significant associations of MEP in urine with headache, repeated coughing, diarrhoea, and hormonal problems were observed. MBzP was associated with repeated coughing and MEHP was associated with itching. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)

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Open AccessCommentary The Life Course Implications of Ready to Use Therapeutic Food for Children in Low-Income Countries
Int. J. Environ. Res. Public Health 2017, 14(4), 403; https://doi.org/10.3390/ijerph14040403
Received: 21 February 2017 / Revised: 22 March 2017 / Accepted: 29 March 2017 / Published: 11 April 2017
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Abstract
The development of ready-to-use therapeutic food (RUTF) for the treatment of uncomplicated cases of severe acute malnutrition in young children from 6 months to 5 years old has greatly improved survival through the ability to treat large numbers of malnourished children in the [...] Read more.
The development of ready-to-use therapeutic food (RUTF) for the treatment of uncomplicated cases of severe acute malnutrition in young children from 6 months to 5 years old has greatly improved survival through the ability to treat large numbers of malnourished children in the community setting rather than at health facilities during emergencies. This success has led to a surge in demand for RUTF in low income countries that are frequently food insecure due to environmental factors such as cyclical drought. Worldwide production capacity for the supply of RUTF has increased dramatically through the expansion and development of new manufacturing facilities in both low and high income countries, and new business ventures dedicated to ready-to-use foods have emerged not only for emergencies, but increasingly, for supplementing caloric intake of pregnant women and young children not experiencing acute undernutrition. Due to the lack of evidence on the long term health impact these products may have, in the midst of global nutrition transitions toward obesity and metabolic dysfunction, the increased use of manufactured, commercial products for treatment and prevention of undernutrition is of great concern. Using a framework built on the life course health development perspective, the current research presents several drawbacks and limitations of RUTF for nutrition of mothers and young children, especially in non-emergency situations. Recommendations follow for potential strategies to limit the use of these products to the treatment of acute undernutrition only, study the longer term health impacts of RUTF, prevent conflict of interests arising for social enterprises, and where possible, ensure that whole foods are supported for life-long health and nutrition, as well as environmental sustainability. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Open AccessBrief Report Assessing a New Method for Measuring Fetal Exposure to Mercury: Newborn Bloodspots
Int. J. Environ. Res. Public Health 2016, 13(7), 692; https://doi.org/10.3390/ijerph13070692
Received: 19 May 2016 / Revised: 28 June 2016 / Accepted: 4 July 2016 / Published: 9 July 2016
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Abstract
Background: Measuring mercury in newborn bloodspots to determine fetal exposures is a novel methodology with many advantages. Questions remain, however, about its reliability as an estimate of newborn exposure to mercury. Methods: We studied mercury concentrations in paired bloodspots and cord blood from [...] Read more.
Background: Measuring mercury in newborn bloodspots to determine fetal exposures is a novel methodology with many advantages. Questions remain, however, about its reliability as an estimate of newborn exposure to mercury. Methods: We studied mercury concentrations in paired bloodspots and cord blood from a convenience sample of 48 Minnesota women and infants. Results: The limit of detection for bloodspots was higher than for cord blood (0.7 and 0.3 μg/L in bloodspots and cord blood, respectively) with the result that mercury was detected in only 38% of newborn bloodspots compared to 62% of cord blood samples. The geometric mean mercury concentration in cord blood was 0.6 μg/L. Mercury concentrations were almost uniformly lower in bloodspots than in cord blood (mean ratio (±SD) = 0.85 ± 0.4), their mean value was significantly less than that for the cord blood (p = 0.02), and the two methods were highly correlated (r = 0.82). Conclusion: These preliminary findings indicate that newborn bloodspot mercury measurements have utility; however, until bloodspot analyses are more sensitive, they are likely to underestimate in utero exposure. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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