Child development knowledge,childrearing attitudes,and social support among first- and second-time adolescent mothers

This paper compares the parenting characteristics of first-and second-time adolescent mothers. Using a case control design, immediately alter delivery and at two months postpartum we administered a pretested questionnaire to 51 second-time adolescent mothers, 47 first-time adolescent mothers, and 25 second-time adult mothers. The questionnaire measured the subject's social support system, contraceptive use, and education level. Scales measuring stressful life events, knowledge of child development, and childrearing attitudes were included. The adolescent groups were similar except that significantly more second-time adolescent mothers dropped out of school (p ≤ 0.05). Greater maternal education and higher infant five-minute Apgar scores were associated with less negative childrearing attitudes immediately after the birth (p ≤ 0.05). At two months postpartum, the age of the father and the time he spent with the child were associated with positive childrearing attitudes (p ≤ 0.05). Increased paternal involvement and completion of high school may enhance adolescent attitudes toward childrearing and improve mother-child relations.     

Parenting Attitudes,Family Environments,Depression, and Anxiety in Caregivers of Maltreated Children

This study evaluated parenting attitudes, family environments, depression, and anxiety in a sample of primarily minority urban mothers to better understand maltreating mothers (n = 83), who retain custody of their children and how they are similar to and different from foster mothers (n = 50), kin caregivers (n = 52) of maltreated children, and comparison mothers (n = 100) from the same communities. Maltreating mothers were distinguished by their much higher levels of depression and anxiety from other mothers. In addition, like foster mothers, maltreating mothers were less likely to approve of corporal punishment. Foster mothers were higher in organization and lower in empathy than other groups. There were no differences by race/ethnicity on study dimensions. Higher education, however, was related to more favorable parenting attitudes and family environments. Practice implications related to appropriate services are suggested.     

Maternal knowledge of nutrition,problem‐solving abilities and the introduction of complementary foods into infants’ diets

The purpose of the present study was to identify variables (maternal knowledge and problem‐solving ability) associated with the early introduction of complementary foods (i.e. foods other than breastmilk or formula) into infants’ diets. Ninety‐eight primarily African‐American mothers who presented to an urban, ambulatory care clinic in the Midwest completed questionnaires. Maternal knowledge regarding doctors’ recommendations for complementary feeding was associated with when mothers introduced solids (r = 0.25, p < .05), cow’s milk (r = 0.35, p < .05), juice (r = 0.42, p < .001) and water (r = 0.38, p < .001). Maternal nutrient knowledge was associated with when cow’s milk (r = 0.37, p < .05) and fruit drink/soda (r = 0.52, p < .01) were introduced. The quality of maternal problem‐solving was associated with when mothers introduced fruit drink/soda (r = 0.34, p < .05). Results underscore the role that healthcare professionals play in complementary feeding.     

Nutrition Education Intervention to Improve Nutrition-Related Knowledge,Attitudes, and Behaviors for Hispanic Children

This study was performed to assess the effect of a nutrition education intervention on the nutrition-related knowledge, attitudes, and behaviors of Hispanic children, ages 6–10 years, in a local after-school program. The intervention included seven weekly lessons that lasted an average of 30 minutes each. Pre- and post-tests were used to evaluate the program. There was a statistically significant difference, p < .04, observed for the intervention group (n = 7) between the pre- and posttest scores for knowledge. In addition, the posttest scores for the intervention group were significantly higher, p < .04, than for the control group (n = 3). Changes in nutrition-related attitudes and behavior were not significant. The only measure that showed significant improvement was knowledge about the differences between healthy and unhealthy food choices after the intervention, which is crucial in the development of healthy behaviors.     

A Group Randomized Trial Evaluating High School FLASH,a Comprehensive Sexual Health Curriculum

PurposeTo evaluate the effectiveness of a school-based comprehensive sexual health curriculum (FLASH) on high-school students’ sexual behavior and related outcomes.MethodsA cohort of 1,597 9th and 10th grade students representing 20 schools from two regions in the U.S. (Midwest and South) were enrolled and completed the baseline survey. Following baseline, the 20 schools were randomly assigned to receive FLASH (n = 10 schools, five per region) or a knowledge-based sexual health curriculum (n = 10 schools, five per region). Follow-up surveys were administered at 3 months and 12 months after the instruction period.ResultsThere were no statistically significant differences between conditions for the overall sample on rates of vaginal sex in the past 3 months or the rates of vaginal sex without a condom or other birth control. In supplementary subgroup analyses of students who were not sexually experienced at baseline, FLASH showed a statistically significant protective impact at the 3-month follow-up on vaginal sex without a condom or birth control (p = .04). FLASH also showed statistically significant gains in psychosocial outcomes, such as refusal and condom use self-efficacy, attitudes toward birth control and condoms, and perceived norms.ConclusionsFLASH demonstrated consistent short-term and long-term impacts on key behavioral determinants. It also showed a significant impact on vaginal sex without a condom or other birth control for the subgroup of students who were not sexually experienced at baseline. Behavioral impacts were not evident for the entire study population.     

Pregnant women's attitudes toward amniocentesis before receiving Down syndrome screening results

OBJECTIVES: We sought to evaluate pregnant women's knowledge about features of second-trimester screening for Down syndrome and to assess whether knowledge and educational level influence their attitude toward amniocentesis before receiving test results. METHODS: Pregnant Caucasian women (n = 300) <35 years old with no personal or family history of Down syndrome were surveyed. Women were randomized to 2 groups. One group of women (n = 150) were surveyed by questionnaire before consultation with specially trained midwives; the other group of women (n = 150) were surveyed after consultation. The questionnaire consisted of 3 sections: 1) participants' demographic data, 2) knowledge about prenatal screening for Down syndrome, and 3) readiness to undergo amniocentesis if there was an increased risk of Down syndrome. RESULTS: Women surveyed after consultation had greater total knowledge scores than those surveyed before consultation (p < .001). A statistically significant difference in knowledge scores in relation to educational levels was observed only in women who were surveyed before consultation (p = .007). Significantly more women were prepared to accept amniocentesis in the group surveyed after consultation (74%) than before consultation (53%; p < .001). CONCLUSION: Knowledge gained during a prescreening consultation influenced pregnant women's attitudes toward further diagnostic investigation. A smaller proportion of women who were indecisive was observed in the group surveyed after prescreening consultation. Indecisiveness was not affected by poor knowledge about screening, but rather by difficulty in knowing how they will feel and what they will do if their screening result is positive.     

Alcohol and adolescents: Knowledge,attitudes, and behavior

Students (n = 3017) from the 6th, 8th, 10th, and 12th grades in six school districts throughout Georgia and South Carolina completed a questionnaire to determine their knowledge, attitudes, and behavior regarding alcohol use. Results suggest that knowledge, attitudes, and behavior are significantly correlated. Two distinct attitudes were discovered: acceptable use of alcohol and unacceptable uses of alochol, and these interacted with knowledge and behavior in different ways. Students who reported school as their major source of information about alcohol were more knowledgeable and had the most conservative attitudes toward unacceptable use of alcohol (p < 0.001). White students scored higher on the knowledge test and had more liberal attitudes than minority students (p < 0.001). Females were more conservative than males (p < 0.001), and older students had more liberal attitudes (p < 0.001). Our results suggest that efforts to educate youth about alcohol should incorporate acceptable uses as well as the negative aspects of drinking.     

Mothers and vaccination: knowledge, attitudes, and behaviour in Italy

The study evaluates knowledge, attitudes, and behaviour of mothers regarding the immunization of 841 infants who attended public kindergarten in Cassino and Crotone, Italy. Overall, 57.8% of mothers were aware about all four mandatory vaccinations for infants (poliomyelitis, tetanus, diphtheria, hepatitis B). The results of a multiple logistic regression analysis showed that this knowledge was significantly greater among mothers with a higher education level and among those who were older at the time of the child's birth. Respondents' attitudes towards the utility of vaccinations for preventing infectious diseases were very favourable. Almost all children (94.4%) were vaccinated with all three doses of diphtheria-tetanus (DT), oral poliovirus vaccine (OPV), and hepatitis B. The proportion of children vaccinated who received all three doses of OPV, DT or diphtheria-tetanus-pertussis (DTP), and hepatitis B vaccines within 1 month of becoming age-eligible ranged from 56.6% for the third dose of hepatitis B to 95.7% for the first dose of OPV. Results of the regression analysis performed on the responses of mothers who had adhered to the schedule for all mandatory vaccinations indicated that birth order significantly predicted vaccination nonadherence, since children who had at least one older sibling in the household were significantly less likely to be age-appropriately vaccinated. The coverage for the optional vaccines was only 22.5% and 31% for measles-mumps-rubella and for all three doses against pertussis, respectively. Education programmes promoting paediatric immunization, accessibility, and follow-up should be targeted to the entire population.     

Perceptions of the birth experience: A cross‐cultural comparison

A comparison of 66 Calgary, Alberta and 294 San Francisco, California first‐time mothers’ perceptions of their birth experiences following vaginal and cesarean births found that both populations perceived the surgical birth less positively. The Calgary group of women as a whole tended to be more traditional in their plans and attitudes toward motherhood; they attended prenatal classes more often, and fewer planned to return to work after the birth of the baby. There were no significant differences in the two populations for those choosing to breastfeed; however, within the combined populations, breastfeeders perceived their birth experience more positively.     

Maternal Nutrition and Birth Size among Urban Affluent and Rural Women in India

Background: Varying results of worldwide intervention programs to pregnant mothers necessitate the need to understand the relationship between maternal nutrition and birth size among well nourished and undernourished mothers.

Objective: To examine this relationship among urban affluent mothers and to compare the findings with those on rural Indian mothers.

Subjects: Data collected on urban affluent mothers (n = 236) was compared with rural mothers (n = 633).

Design: Mothers were contacted at 18 ± 2 and 28 ± 2 wk of gestation for anthropometry, dietary intakes [24-hr recall, Food Frequency Questionnaire (FFQ)] and after delivery for neonatal anthropometry.

Results: Despite large differences in nutritional status of urban and rural mothers ( pre-pregnant weight 55.9 ± 9.2 Vs 41.5 ± 5.2 kg, respectively) maternal fat intakes at 18 wk were associated with birth weight (p < 0.05), length (p < 0.01) and triceps skin fold thickness (p < 0.05) of the newborn in urban and rural mothers. Consumption of fruits was associated with birth length (p < 0.05) in urban (18wk) and with birth weight (p < 0.01) and length (p < 0.01) in rural (28wk) mothers, when their energy intakes were low. Maternal consumption of milk too, was associated with newborn's triceps (p < 0.01) in urban (28wk) while with birth weight (p < 0.05) and length (p < 0.05) in rural (18wk) mothers. The findings mainly underscore the importance of consumption of micronutrient rich foods, when energy intakes are limiting during pregnancy, for improving birth size.

Conclusions: Creating nutritional awareness and motivating rural mothers for consuming micronutrient rich foods like green leafy vegetables and seasonal fruits that are easily available in rural areas, will be a much affordable solution for combating the problem of low birth weight rather than waiting for improvement in the existing nationwide programs for pregnant women.     

Anthropometric predictors of low birth weight outcome in teenage pregnancy

The highest relative risks of low birth weight are found among births to teenage mothers. An analysis of anthropometrics (weight, mid-arm circumference, and triceps skinfold) among black teenagers attending an adolescent prenatal program was studied. The sample consisted of 100 girls under 17 years. Data were collected from 19 to 35 weeks gestation. Adolescent mothers who delivered low birth weight (LBW) infants demonstrated different patterns of anthropometric changes than teen mothers who delivered normal birth weight (NBW) infants. Mean mid-arm circumference increases in the LBW group (0.05 mm/wk) were significantly less than mean increases in the NBW group (0.80 mm/wk) (p < 0.05). Arm fat area estimates of the LBW mothers demonstrated weekly depletion (−24.9 mm²/wk), which was significantly less than those of the NBW group, who accumulated fat (+ 15.3 mm²/wk) (p < 05). Changes in maternal nutritional status may in part mediate the birthweight outcome in adolescent pregnancy. Anthropometrics may be useful in predicting the teens at highest risk of bearing LBW infants.     

Mothers Who Do and Do Not Intend to Discuss Sexual Health With Their Young Adolescents

This study distinguished two groups of mothers who have not communicated with their young adolescents about sexual health based on their intentions of having these discussions. We also compared these 2 groups to mothers who have had such communications. Overall, 29% of mothers had engaged in sexual discussions with their adolescent in some detail (active group), 22% intended to do so in the next 6 months (intender group), and 49% did not intend to do so in the next 6 months (nonintender group). Higher scores on variables consistent with the integrative model of behavioral prediction (parent knowledge, comfort, attitudes, perceptions of social norms, and self‐efficacy for sexual communication) differentiated the 3 groups: The active group had the highest scores, the nonintender group had the lowest scores, and the scores of the intender group fell in between. Group membership varied by sexual topic. Suggestions for enhancing parent‐adolescent sexual communication are discussed.     

The Association between Maternal Stress and Glucocorticoid Rhythmicity in Human Milk

Background: Chronic stress is often accompanied by alterations in the diurnal rhythm of hypothalamus–pituitary–adrenal activity. However, there are limited data on the diurnal rhythmicity of breast milk glucocorticoids (GCs) among women with psychological distress. We compared mothers who sought consultation at an expertise center for pregnant women with an increased risk of psychological distress with control mothers for GC diurnal rhythmicity in milk and saliva obtained at the same time. Methods: We included 19 mothers who sought consultation at the psychiatry–obstetric–pediatric (POP) outpatient clinic and 44 control mothers. One month postpartum, mothers collected on average eight paired milk and saliva samples during a 24 h period. GC levels were measured using liquid chromatography–tandem mass spectrometry. GC rhythmicity parameters were determined with specialized software. Results: For both milk and saliva, no group differences regarding GC rhythms were found. Milk cortisol area under the curve with respect to the ground was lower in the POP group than in the control group (p = 0.02). GC levels in human milk and saliva were highly correlated within each group (p < 0.001). Conclusion: Although there were no differences between groups in GC rhythmicity, the total amount of milk cortisol was lower in the POP group. Long-term follow-up is needed to address the impact of vertical transmission of breast milk GCs.     

Knowledge,attitudes and behaviours in relation to safe sex,sexually transmitted infections (STI) and HIV/AIDS among remote living north Queensland youth

Objective: To assess the knowledge, attitudes and behaviours of remote Aboriginal and Torres Strait Islander youth living in far north Queensland in relation to sexually transmitted infections, HIV/AIDS and safe sex. Methods: Community consultation followed by local recruitment of a sample of young people who, in a facilitated same gender focus group setting, completed a questionnaire followed by open discussion of the issues in a range of remote locations during 2007. Results: The remote living Indigenous youth demonstrated lower levels of knowledge in relation to STI and HIV and higher levels of partner change than was demonstrated in the 2002 national secondary school survey. Despite the high rates of bacterial STI in the region, there was an extremely low level of awareness of personal risk in relation to STI and HIV. Conclusion: There is an urgent need to strengthen school‐based sex education and to develop innovative approaches to sexual health promotion in addition to improving clinical sexual health service provision.     

Preventive Healthcare of Infants in a Region of Lebanon: Parental Beliefs,Attitudes and Behaviors

Objectives: This study aimed to investigate healthcare seeking behaviors of mothers for themselves and their infants in the Bekaa Valley, Lebanon, to identify attitudes and beliefs towards the preventive healthcare of infants and to assess whether a healthcare-based intervention program would be accepted by the population. Methods: Ninety-two interviews were conducted with women who had delivered a live birth in two hospitals in the Bekaa. The hospitals selected attracted women from different socioeconomic classes. Results: Differences were found in adequacy of healthcare utilization based on household size, number of children and prenatal care utilization. There was a higher perception of barriers to healthcare by parents who did not seek adequate preventive care for their infants. Mothers of infants who had inadequate care had a lower perception of severity of illness and of physicians ability to prevent illness. The population believes strongly that medical professionals are reliable sources of health information and guidance. Infants mothers and grandmothers are important sources of healthcare-related information. Conclusions: Rates of preventive infant healthcare in the Bekaa need improvement. Any intervention must target mothers and grandmothers, as they appear to influence the medical care of infants. Other targets include parents of larger families. Dissemination of information regarding the seriousness of illness and the ability to prevent illness is required. The medical profession may influence health choices made by this population. However, further investigation of healthcare barriers, especially economic and geographic barriers, is needed. In preparing to improve healthcare utilization for infants in the Bekaa, local, regional and international organizations should refer to the populations beliefs, attitudes and behaviors described in this study, as these findings may aid in planning interventions that are likely to positively impact mothers and infants.     

正常产后48h母婴出院联合家庭访视的可行性研究

目的:评价经选择的母婴正常产后48 h出院联合家庭访视的可行性。方法:选择在深圳妇幼保健院正常产并接受产后家庭访视的10 172例产妇和9 297例新生儿为研究A组,同期拆线后出院的正常产产妇5 286例和新生儿4 604例为对照A组,比较两组产妇会阴伤口愈合不良发生率和婴儿再入院率。产后42天对1 000例产妇进行有关母乳喂养和产褥期母婴情况的问卷调查,按照是否曾接受产后访视将调查对象分为研究B组和对照B组,比较两组母乳喂养成功率和产褥期抑郁症的发生率。结果:通过产后家庭访视,平均缩短住院时间(1.76±0.44)天,研究A组产妇会阴伤口愈合不良发生率明显低于对照A组(P<0.05);研究A组婴儿再入院率和对照A组相比,差异无统计学意义(P>0.05);研究B组母乳喂养成功率明显高于对照组(P<0.05);研究B组产褥期抑郁症的发生率明显低于对照B组(P<0.05)。结论:对于经过选择的低风险产妇和婴儿,正常产后48 h出院联合家庭访视安全、经济、有效。     

Relationship between perception of self‐competence and parenting attitudes of Asian Indian preschoolers

The purpose of the present study is to examine the relationship between parenting attitudes of Asian Indian mothers living in the United States and their preschool children’s perception of self‐competence. Twenty‐eight Asian Indian mothers and their preschool‐aged children living in the United States participated in the study. The parenting attitudes of the mothers were measured using the Adolescent–Adult Parenting Inventory. The participating preschoolers’ perceived self‐competence was measured using the Pictorial Scale of Perceived Competence and Social Acceptance. Correlation of the parenting attitudes subscales and the perception of self‐competence subscales indicated that there was significant correlation between cognitive competence and inappropriate expectations (r = 0.45, p < 0.05), corporal punishment (r = 0.46, p < 0.05), and role reversal (r = 0.59, p < 0.01). Role reversal was also significantly correlated with peer acceptance (r = 0.46, p < 0.05). The correlation between inappropriate expectations, corporal punishment, role reversal and cognitive competence among the Asian Indian children could be attributed to the values their parents place on cognitive skills.     

Low Birth Weight Across Generations

Objectives: This study sought to determine the relationship between maternal birth weight, prenatal care usage, and infant birth weight. Methods: Stratified and logistic regression analyses were performed on a dataset of computerized Illinois vital records of White (N = 187,074) and African-American (N = 58,856) infants born between 1989 and 1991 and their mothers born between 1956 and 1975. Results: Among White mothers who received adequate prenatal care, the low birth weight (<2500 g) rate was 4% for infants of former low birth weight mothers (N = 5230) compared to 2.1% for infants of former nonlow birth weight mothers (N = 93,011), relative risk equaled 1.9(1.7–2.2); the population attributable risk of maternal low birth weight was 4.1%. Among African American mothers who received adequate prenatal care, the low birth weight rate was 15% for infants of former low birth weight mothers (N = 2196) compared to 7.2% for infants of former nonlow birth weight mothers (N = 14,607), relative risk equaled 2.1(1.9–2.4); the population attributable risk of maternal low birth weight was 10.9%. The maternal–infant birth weight associations were consistent across all maternal age, education, marital status, and prenatal care categories. Conclusions: Maternal low birth weight is a risk factor for infant low birth weight independent of risk status during the current pregnancy. A greater percentage of low birth weight African American (compared to White) infants are attributable to maternal low birth weight.     

The Influence of Maternal Mobility on Birth Outcomes of non-Hispanic Blacks

Background We investigated whether the “healthy migrant” effect is applicable to an internally mobile U.S.-born population, that is, whether infants born to women that moved within the United States had better birth outcomes compared to those infants whose mothers did not move. Methods This study used 1995–2001 National Center for Health Statistics live birth/infant death cohort files of singleton infants born in the U.S. to non-Hispanic Black women. Results Infants born to women who moved had significantly lower risks of low birth weight, preterm birth, and SGA compared to the non-mobile group. Conclusions There is evidence to support the healthy migrant effect in an internally migrant Black population. The findings of this study suggest infants of non-Hispanic Black mothers who were born in one state and moved prior to delivery had more positive birth outcomes when compared to those infants of women who did not move prior to delivery. Greg R. Alexander is deceased.