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Brief Communication
Assessing the impact and implications of the revised Act on the Aggravated Punishment of Specific Crimes in preventing child traffic injuries in school zones in Korea: an interrupted time series analysis
Hong Jin Ku, Jin-Hwan Kim, Young June Choe, Seung Ah Choe, Mark R. Zonfrillo
Epidemiol Health. 2024;46:e2024032.   Published online February 21, 2024
DOI: https://doi.org/10.4178/epih.e2024032
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AbstractAbstract AbstractSummary PDF
Abstract
In 2019, a child’s death in Korea led to legislation that imposed stricter penalties for school zone traffic violations. We assessed the impact of that legislation using 2017-2022 Traffic Accident Analysis System data. Adjusted analyses revealed a significant decline in severe injuries in school zones, decreasing from 11 cases to 8 cases per month (p=0.017). The legislation correlated with a reduced risk of all child traffic injuries (risk ratio, 0.987; 95% confidence interval, 0.977 to 0.997; p=0.002), indicating its efficacy in curbing accidents.
Summary
Korean summary
2019년 민식이법 도입 후 소아 교통사고에 미치는 영향을 평가하고자 하였다. 2017-2022 교통사고 분석 시스템 데이터를 통해 그 효과를 평가했고, 학군지역에서 심각한 부상이 월 평균 11건에서 8건으로 감소했다(p=0.017). 또한, 모든 어린이 교통사고 위험 비율도 감소했고(risk ratio, 0.987, 95% CI, 0.977-0.997; p=0.002), 사고 예방에 효과적임을 입증했다. 이 연구는 학군지역 어린이 안전에 법 조치의 긍정적 영향을 강조하며, 지속적인 도로 안전 강화의 중요성을 강조한다.
Key Message
Revised legislation in Korea, following a child’s tragic death, enforced stricter penalties for school zone traffic violations. Analysis of 2017-2022 data showed a significant decrease in severe injuries from 11 to 8 cases monthly (p=0.017). The legislation also reduced the risk of all child traffic injuries (risk ratio, 0.987; 95% CI, 0.977 to 0.997; p=0.002), demonstrating its effectiveness in preventing accidents. This study underscores the legislation’s positive impact on child safety in school zones, emphasizing the importance of ongoing enforcement efforts for road safety.
Original Articles
Associations between adverse childhood experiences and diabetes among middle-aged and older Chinese: a social-ecological perspective
Siyu Zhu, Leying Hou, Jiaying Ma, Shuting Li, Weidi Sun, Wen Liu, Jiajun Hao, Wenhan Xiao, Siqing Cheng, Dexing Zhang, Dong Zhao, Peige Song
Epidemiol Health. 2023;45:e2023071.   Published online August 2, 2023
DOI: https://doi.org/10.4178/epih.e2023071
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined the associations between adverse childhood experiences (ACEs) and diabetes within a social-ecological framework, incorporating personal and environmental unfavorable conditions during childhood from family, school, and community contexts.
METHODS
Data were obtained from the China Health and Retirement Longitudinal Study (2014 life history survey and 2015 survey), including 9,179 participants aged ≥45 years. ACEs were collected through self-report questionnaires, and participants were categorized based on the number of distinct ACEs experienced (0, 1, 2, 3, or ≥4 ACEs). Diabetes was defined by biomarkers, self-reported diagnosis, and treatment status. Logistic regression was conducted to explore the associations between ACEs and diabetes. Subgroup analyses were conducted by gender, age, and obesity status.
RESULTS
Compared with participants without ACEs, those exposed to any ACE (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40), 3 ACEs (OR, 1.32; 95% CI, 1.07 to 1.62) and ≥4 ACEs (OR, 1.29; 95% CI, 1.07 to 1.56) had an increased risk of diabetes. For each additional ACE, the risk of diabetes increased by about 5%. Regarding the source of ACEs, those originating from the family (OR, 1.23; 95% CI, 1.08 to 1.41) were associated with diabetes. In terms of specific ACE types, family members with substance abuse (OR, 1.23; 95% CI, 1.01 to 1.52), emotional abuse (OR, 1.28; 95% CI, 1.12 to 1.46), and poor parental relationship (OR, 1.25; 95% CI, 1.09 to 1.43) were associated with diabetes.
CONCLUSIONS
ACEs, particularly those originating from the family, were associated with diabetes. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.
Summary
Key Message
From a social-ecological perspective, this study delineates an association between adverse childhood experiences (ACEs), particularly those originating from the family, and diabetes among middle-aged and older Chinese. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.
Age at first childbirth and the risk of hypertriglyceridemia among Korean women
Hye Rin Choi, Hyeon Chang Kim
Epidemiol Health. 2023;45:e2023010.   Published online December 29, 2022
DOI: https://doi.org/10.4178/epih.e2023010
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  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to investigate the association of age at first childbirth with the risk of hypertriglyceridemia among Korean women.
METHODS
This study used data from the Korean Genome and Epidemiology Study–Cardiovascular Disease Association Study. In total, 16,747 women were included in the cross-sectional analysis, and 6,250 women were included in the longitudinal analysis. The participants were divided based on their age at first childbirth (<20, 20-24, 25-29, and ≥30 years). Hypertriglyceridemia was defined as triglyceride levels of ≥150 mg/dL.
RESULTS
The multivariable-adjusted odds ratio for prevalent hypertriglyceridemia was 1.19 (95% confidence interval [CI], 1.01 to 1.40) in women whose first childbirth was before 20 years of age, compared to those whose first childbirth was at 25-29 years of age, after adjustment for age, study site, body mass index, blood pressure, diabetes, alcohol consumption, carbohydrate intake, income, marital status, education, parity, usage of oral contraceptives, and hormone replacement status. During a median follow-up of 5.2 years, 1,770 women developed hypertriglyceridemia. Compared with women who gave birth to their first child between 25 years and 29 years of age, those giving birth to their first child before 20 years of age had a higher risk for incident hypertriglyceridemia in later life (adjusted hazard ratio, 1.25; 95% CI, 0.99 to 1.57).
CONCLUSIONS
Giving birth to one’s first child before the age of 20 years was associated with an increased risk of hypertriglyceridemia among Korean women.
Summary
Korean summary
한국인유전체역학조사사업의 농촌기반 코호트 자료를 분석한 결과, 20세 이전에 초산을 경험한 한국 여성에서 25-29세에 경험한 군에 비해 고중성지방혈증에 걸릴 위험이 증가하였음 폐경 후 여성을 한정하여 보았을 때도 20세 이전 초산과 고중성지방혈증 간의 유의한 관련성을 보였음 여성의 출산 등 여성력이 심혈관계 질환 발생의 위험요인으로 작용할 수 있으며, 출산력에 따른 혈중 중성지방수치 관리 전략 마련이 필요함
Key Message
Among Korean women, having their first child before the age of 20 was associated with an increased risk of hypertriglyceridemia. Targeted preventive actions should be developed for those women who give birth at an early age in order to manage their blood triglyceride levels.

Citations

Citations to this article as recorded by  
  • Adolescent childbirth and mobility disability among women ages 15–49: an analysis of population health surveys from 14 low-income and middle-income countries
    Katherine E Peck, Diego G Bassani, Saionara MA Camara, Marlos R Domingues, Tetine Sentell, Maria P Velez, Catherine M Pirkle
    BMJ Open.2023; 13(7): e072535.     CrossRef
Parental concerns about COVID-19 vaccine safety and hesitancy in Korea: implications for vaccine communication
Hye-Kyung Cho, Hyunju Lee, Young June Choe, Shinkyeong Kim, Sujin Seo, Jiwon Moon, Eun Hwa Choi, Geun-Yong Kwon, Jee Yeon Shin, Sang-Yoon Choi, Mi Jin Jeong, Myoungsoon You
Epidemiol Health. 2023;45:e2023004.   Published online December 13, 2022
DOI: https://doi.org/10.4178/epih.e2023004
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  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Vaccination is one of the most important strategies to contain the spread of coronavirus disease 2019 (COVID-19). Vaccination in children is dependent on their parents, making it important to understand parents’ awareness and attitudes toward vaccines in order to devise strategies to raise vaccination rates in children.
METHODS
A web-based nationwide survey was conducted among Korean parents of 7-year-old to 18-year-old children in August 2021 to estimate parents’ intention to vaccinate their children against COVID-19 and identify key factors affecting parental acceptance and hesitancy through regression analysis.
RESULTS
Approximately 56.4% (575/1,019) were willing to vaccinate their children against COVID-19. Contributing factors to COVID-19 vaccine hesitancy were being a mother (adjusted odds ratio [aOR], 0.36; 95% confidence interval [CI], 0.25 to 0.52), a lower education level (aOR, 0.83; 95% CI, 0.70 to 0.97), hesitancy to other childhood vaccines (aOR, 0.78; 95% CI, 0.64 to 0.96), and refusal to vaccinate themselves (aOR, 0.08; 95% CI, 0.02 to 0.20). Having older children (aOR, 1.20; 95% CI, 1.13 to 1.28), trusting the child’s doctor (aOR, 1.19; 95% CI, 1.07 to 1.32), positive perceptions of the COVID-19 vaccine’s effectiveness (aOR, 2.60; 95% CI, 1.90 to 3.57) and perceiving the COVID-19 vaccine as low-risk (aOR, 1.68; 95% CI, 1.27 to 2.24) were associated with COVID-19 vaccine acceptance. Concerns about adverse reactions were the most common cause of hesitancy.
CONCLUSIONS
Providing parents with accurate and reliable information on vaccine effectiveness and safety is important to increase COVID-19 vaccine uptake in children. Differential or targeted approaches to parents according to gender, age, and their children’s age are necessary for effective communication about vaccination in children.
Summary
Korean summary
부모에게 백신 효과와 안전성에 대한 정확하고 믿을만한 정보를 제공하는 것이 소아 코로나19 백신 접종률을 높이는데 중요하다. 자녀의 백신 접종에 대한 의사소통을 효율적으로 하기 위해서는 부모의 성별과 연령, 자녀의 연령을 고려한 차별적인 접근 방법이 필요하다.
Key Message
To improve COVID-19 vaccine uptake in children, it's crucial to provide parents with reliable and precise information about vaccine safety and effectiveness. Targeted communication strategies that consider factors such as the age of the parents and their children, as well as gender, may be necessary to effectively convey this information.

Citations

Citations to this article as recorded by  
  • Safety of BNT162b2 mRNA COVID-19 vaccine in children with chronic kidney disease: a national population study from South Korea
    Young June Choe, Yo-Han Ahn, Eunsun Gwak, Eunseo Jo, Jinseob Kim, Seung-Ah Choe
    Pediatric Nephrology.2024; 39(2): 625.     CrossRef
  • Assessing the determinants of influenza and COVID-19 vaccine co-administration decisions in the elderly
    Seunghyun Lewis Kwon, So-Yeon Kim, Minju Song, Hyung-Min Lee, Seon-Hwa Ban, Mi-Soon Lee, Hyesun Jeong
    Human Vaccines & Immunotherapeutics.2024;[Epub]     CrossRef
  • Descriptive cross-sectional study to evaluate perception, attitude, and practice of parents regarding COVID-19 vaccination in children 10–12 years of age—A step toward prevention of future COVID-19 outbreaks in India
    Vivek Mehta, Deep Inder, Pawan Kumar, Anupma Raheja
    Journal of Family Medicine and Primary Care.2024; 13(5): 2104.     CrossRef
  • Willingness and hesitancy of parents to vaccinate against COVID-19 their children ages 6 months to 4 years with frail conditions in Italy
    Grazia Miraglia del Giudice, Giorgia Della Polla, Mario Postiglione, Italo Francesco Angelillo
    Frontiers in Public Health.2023;[Epub]     CrossRef
Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study
Fadila Wirawan, Dieta Nurrika
Epidemiol Health. 2022;44:e2022100.   Published online November 1, 2022
DOI: https://doi.org/10.4178/epih.e2022100
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Anemia in children under 5 years of age is often overlooked despite its detrimental effects. The public health approach to anemia prevention includes the maternal pre-pregnancy phase. This study investigated the association between pre-pregnancy anemia and the risk of anemia in children under 5 years of age.
METHODS
This cohort study included non-pregnant women from the 2007 Indonesian Family Life Survey (IFLS) and their children under 5 in the 2014 IFLS. The anemia status of mothers and children was determined based on hemoglobin (Hb) levels using Hemocue. Mantel-Haenszel adjusted relative risks (aRRs), including risk stratification by covariates, were used for the final risk assessment.
RESULTS
In total, 637 children in the 2014 IFLS were included. The risk of having a child with anemia was 1.71-fold higher in women with pre-pregnancy anemia than in women without pre-pregnancy anemia (aRR, 1.71; 95% confidence interval [CI], 1.03 to 2.85). After risk stratification based on potential confounding variables, maternal pre-pregnancy anemia remained an independent risk factor for anemia in children who still breastfed at the time of data collection (relative risk [RR], 2.11; 95% CI, 1.16 to 3.86), in children who were given water earlier than 6 months of age (RR, 2.08; 95% CI, 1.20 to 3.61), in children of mothers with a normal or underweight pre-pregnancy body mass index (RR, 1.94; 95% CI, 1.20 to 3.14), and in children of mothers without current anemia (RR, 2.20; 95% CI, 1.21 to 3.99).
CONCLUSIONS
Pre-pregnancy anemia increased the risk of childhood anemia. A public health approach emphasizing pre-conception maternal health would enable better maternal and child morbidity risk prevention.
Summary
Key Message
Pre-pregnancy anemia increased the risk of childhood anemia by 1.7 times compared to without pre-pregnancy anemia, and increased when the child was still breastfed, given water before 6 months of age, and the mother had a normal or underweight pre-pregnancy BMI, regardless of the mother’s current no anemia status.

Citations

Citations to this article as recorded by  
  • Identification and treatment of iron‐deficiency anemia in pregnancy and postpartum: A systematic review and quality appraisal of guidelines using AGREE II
    Victoria Mintsopoulos, Evan Tannenbaum, A. Kinga Malinowski, Nadine Shehata, Melissa Walker
    International Journal of Gynecology & Obstetrics.2024; 164(2): 460.     CrossRef
  • Prevalence and risk factors of anemia in the mother–child population from a region of the Colombian Caribbean
    Lisetta Del Castillo, Nora Cardona-Castro, Denis R. Whelan, John Paul Builes, Héctor Serrano-Coll, Margarita Arboleda, Juan S. Leon
    BMC Public Health.2023;[Epub]     CrossRef
  • Iron deficiency anemia in pregnant women
    L. D. Belotserkovtseva, L. V. Kovalenko, V. N. Zinin, S. E. Ivannikov, M. R. Keldasova
    Ural Medical Journal.2023; 22(5): 140.     CrossRef
  • Safety monitoring of oral iron supplements in pregnant women with anemia: a multi-center observational clinical study
    Chang Liu, Qianqian Zhang, Peiye Hui, Yan Wang, Guohui Li, Guangchao Cao, Zicheng Xue, Jing Zhang, Heng Zhang, Xin Huang, Jiyong Wu, Fusehng Sun, Meixing Yan
    Therapeutic Advances in Drug Safety.2023;[Epub]     CrossRef
Aspergillus sensitization associated with current asthma in children in the United States: an analysis of data from the 2005-2006 NHANES
Hui-Ju Wen, Shu-Li Wang, Ming-Chieh Li, Yue Leon Guo
Epidemiol Health. 2022;44:e2022099.   Published online October 28, 2022
DOI: https://doi.org/10.4178/epih.e2022099
  • 4,360 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the association between allergen sensitization and current asthma in children in the United States using data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES).
METHODS
Children who participated in the 2005–2006 NHANES, aged 6 years to 19 years, were included in this study. A structured questionnaire was used to assess asthma status (without asthma, asthma in remission, or current asthma). Nineteen specific immunoglobulin E (sIgE) levels were measured using the Pharmacia Diagnostics ImmunoCAP 1000 System (Kalamazoo, MI, USA). A machine-learning method was applied to select important sIgEs related to childhood asthma. Multivariate regression analysis was used to test this hypothesis.
RESULTS
In total, 2,875 children were recruited. The prevalence of ever having asthma and current asthma was 16.5% and 5.6%, respectively. Six sIgE levels were found to contribute to asthma using bootstrap forest selection. After adjusting for the child’s sex, age, and family income, children with double the sIgE levels of <i>Dermatophagoides farinae</i>, dogs, and <i>Aspergillus</i> were more likely to have current asthma than children without asthma (odds ratio [95% confident interval]: 1.11 [1.04 to 1.19], 1.30 [1.16 to 1.46], and 1.55 [1.39 to 1.72], respectively).
CONCLUSIONS
Our findings suggest that allergen sensitization, especially to <i>Aspergillus</i>, is associated with current asthma in children. Strategies to reduce sensitization may help prevent and manage asthma.
Summary
Key Message
This investigation studied 2,875 children from the National Health and Nutrition Examination Survey (NHANES) 2005-2006, aged less than 19 years, for the association between allergen sensitization and persistent asthma. Six specific IgE levels (i.e. Dermatophagoides farina, Dermatophagoides pteronyssinus, cat, dog, Alternaria, and Aspergillus) were found to contribute to asthma using bootstrap forest selection. Our findings suggested that allergen sensitization, especially to Aspergillus, is associated with asthma persistence in children after adjusting for potential confounders. Strategies to reduce sensitization may help prevent and manage asthma.

Citations

Citations to this article as recorded by  
  • Age-related differences in IgE between childhood and adulthood allergic asthma: Analysis of NHANES 2005–2006
    Heping Fang, Juan Li, Luo Ren, Enmei Liu
    World Allergy Organization Journal.2023; 16(12): 100842.     CrossRef
Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from the National Health Database 2015-2019
Suchaorn Saengnipanthkul, Jeeraparn Phosuwattanakul, Kaewjai Thepsuthammarat, Nalinee Chongviriyaphan
Epidemiol Health. 2022;44:e2022047.   Published online May 16, 2022
DOI: https://doi.org/10.4178/epih.e2022047
  • 8,299 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Malnutrition in hospitalized patients is a frequently overlooked health issue. We aimed to assess the prevalence and pattern of nutritional disorders in hospitalized Thai children from the National Health Database.
METHODS
Hospitalized children aged 1 month to 18 years diagnosed with nutritional disorders between 2015 and 2019 were retrospectively reviewed using the National Health Security Office data. Based on the International Classification of Diseases, 10th revision, Clinical Modification, nutritional disorders were classified into 3 major forms of malnutrition: undernutrition (E40-E46), overweight and obesity (E66), and micronutrient deficiencies (D50-D53, E50-E56, E58, E60-E61, and E63).
RESULTS
Out of 5,188,033 hospitalized children, malnutrition was identified in 115,254 (2.2%). Protein-energy malnutrition (PEM), overweight and obesity, and micronutrient deficiencies were prevalent in 0.21%, 0.27%, and 1.81%, respectively. Among those with micronutrient deficiencies, 95.0% had iron deficiency anemia, 2.2% had vitamin D deficiency, and 0.7% had zinc deficiency. Children aged under 5 years mostly had PEM, followed by iron deficiency anemia. Teenagers commonly had obesity and vitamin D deficiency. Patients with PEM who were admitted with common diseases had significantly longer hospital stays and higher hospital costs and mortality rates than those without PEM.
CONCLUSIONS
Hospitalized children had various nutritional disorders, particularly PEM, which was associated with higher morbidity and mortality. Nutritional screening tools should be utilized for the early detection and treatment of malnutrition. Specific International Classification of Diseases codes for nutritional care services and intervention should be available. Additionally, nutritional interventions should be reimbursed, along with nutritional education and empowerment of healthcare providers, to improve hospital care service and improve patient outcomes.
Summary
Key Message
Malnutrition is common among hospitalized Thai children, particularly protein energy malnutrition; it increases mortality, length of hospital stay, and hospital costs as well as exerts long-term effects on growth and development. Prevalence of overweight and obesity is increasing over the past 5 years, the vast majority involved patients 5 – 13 years of age.

Citations

Citations to this article as recorded by  
  • The Low Sensitivity and Specificity of a Nutrition Screening Tool in Real Circumstances in a Tertiary Care Hospital Setting
    Nithit Semsawat, Oraporn Dumrongwongsiri, Phanphen Phoonlapdacha
    Children.2023; 10(4): 747.     CrossRef
Cohort Profile
The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile
Chris Desmond, Gabriella A. Norwitz, Jane D. Kvalsvig, Rachel S. Gruver, Shuaib Kauchali, Kathryn G. Watt, Nonhlanhla P. Myeza, Adele Munsami, Leslie L. Davidson
Epidemiol Health. 2022;44:e2022037.   Published online April 5, 2022
DOI: https://doi.org/10.4178/epih.e2022037
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AbstractAbstract AbstractSummary PDF
Abstract
The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003-2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children’s primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere.
Summary
Key Message
The Asenze Cohort Study, one of a limited number of population-based studies set in low- and middle-income countries, with a high level of retention, provides an understanding of neuro-developmental, psychosocial, home environmental and economic exposures and outcomes of over 1100 adolescents and their primary caregivers in KwaZulu-Natal, South Africa.

Citations

Citations to this article as recorded by  
  • The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa
    Gabriella A. Norwitz, Chris Desmond, Rachel S. Gruver, Jane D. Kvalsvig, Amaleah F. Mirti, Shuaib Kauchali, Leslie L. Davidson, Giulia Ballarotto
    PLOS ONE.2023; 18(10): e0290788.     CrossRef
Original Articles
Association between dietary and suicidal behaviors in adolescents in Korea based on the Youth Risk Behavior Survey (2015-2020)
Youngrong Lee, Ye Jin Jeon, Jee-Seon Shim, Sun Jae Jung
Epidemiol Health. 2022;44:e2022033.   Published online March 12, 2022
DOI: https://doi.org/10.4178/epih.e2022033
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study explored the association between dietary and suicidal behaviors of Korean adolescents and investigated differences in this association in children of immigrant parents.
METHODS
The sample (n=368,138) was collected from the Korea Youth Risk Behavior Survey from 2015 to 2020. Participants who agreed to provide family information (n=313,689) were classified according to their parents’ nationality. The study variables were 11 self-reported dietary behaviors, and their composite dietary behaviors (i.e., nutrient deprivation and unhealthy food consumption) that resulted from principal component analysis. The association between study variables and suicide-related outcomes (i.e., suicidal ideation, suicide planning, and suicide attempts) was analyzed by multiple logistic regression with adjustment for covariates. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.
RESULTS
Participants who skipped key meals and foods were more likely to have attemped suicide (aOR [95% CI]: skipping breakfast ≥5 days/wk, 1.28 [1.21 to 1.35]; consuming fruits <1 times/wk: 1.42 [1.32 to 1.52]; consuming vegetables <1 times/wk: 1.72 [1.53 to 1.93]; consuming milk <3 times/wk: 1.07 [0.99 to 1.16]). The associations were prominent in third culture kids (TCKs) (aOR [95% CI]: 2.23 [1.61 to 3.09]; 2.32 [1.61 to 3.35]; 2.63 [1.50 to 4.60]; 1.69 [1.09 to 2.63], respectively). Participants who consumed unhealthy foods (fast food, caffeinated and sugary drinks) more frequently were more likely to have attempted suicide (aOR, 1.55; 95% CI, 1.38 to 1.73). This association was also more prominent in TCKs (aOR, 2.08; 95% CI, 1.08 to 4.01).
CONCLUSIONS
Our findings indicate a positive association between unfavorable dietary behaviors and outcomes related to suicide, and this association appears to be notable in adolescents with immigrant parents.
Summary
Korean summary
• 한국 청소년의 식이 행동과 자살 행동 사이의 연관성과 한국인 부모와 이민자 부모 자녀에서 위의 연관성 차이를 조사하였다. • 청소년의 결식 빈도 증가, 과일, 야채, 우유 섭취 감소는 자살 행동과 유의한 연관성이 있었으며 이민자 부모를 둔 청소년에서 연관성의 크기가 더 컸다. • 패스트푸드, 카페인, 가당 음료, 인스턴트 음식을 더 자주 섭취하는 청소년은 자살을 시도할 가능성이 더 높았으며 이민자 부모를 둔 청소년에서 더 큰 연관성을 보였다.
Key Message
The study found positive associations between undesirable dietary behaviors (e.g., skipping breakfast, increased consumption of fast food or instant food product) and outcomes related to suicide (i.e., suicide ideation, planning, and attempt) in Korean adolescents, and these associations appear to be prominent in adolescents with immigrant parents than those with Korean parents.

Citations

Citations to this article as recorded by  
  • Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017–2021: focusing on the comparisons before and during the COVID-19 pandemic
    Mi-Sun Lee, Dong Jun Kim, Hooyeon Lee
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Association between body shape misperception and unhealthy eating behaviors among Korean adolescents
    Yejin Kim, Bomgyeol Kim, Vasuki Rajaguru, Sang Gyu Lee, Tae Hyun Kim
    Nutrition Research and Practice.2023; 17(6): 1143.     CrossRef
Age-specific effects of ozone on pneumonia in Korean children and adolescents: a nationwide time-series study
Kyoung-Nam Kim, Youn-Hee Lim, Sanghyuk Bae, In Gyu Song, Soontae Kim, Yun-Chul Hong
Epidemiol Health. 2022;44:e2022002.   Published online December 28, 2021
DOI: https://doi.org/10.4178/epih.e2022002
  • 11,613 View
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  • 3 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to estimate the age-specific effects of 8-hour maximum ozone levels on pneumonia in children and adolescents.
METHODS
We performed quasi-Poisson regression analyses for individuals of 0-4 years, 5-9 years, 10-14 years, and 15-19 years of age using nationwide time-series data from the Korea (2011-2015). We constructed distributed lag linear models employing a generalized difference-in-differences method and controlling for other air pollutants.
RESULTS
A 10.0-parts per billion increase in 8-hour maximum ozone levels was associated with a higher risk of hospital admissions due to pneumonia at 0-4 (relative risk [RR], 1.02; 95% confidence interval [CI], 1.01 to 1.03) and 5-9 years of age (RR, 1.06; 95% CI, 1.04 to 1.08), but not at 10-14 (RR, 1.01; 95% CI, 0.98 to 1.04) or 15-19 years of age (RR, 1.01; 95% CI, 0.97 to 1.06). The association between ozone and hospital admissions due to pneumonia was stronger in cool seasons (from November to April) than in warm seasons (from May to October), but was similar between boys and girls.
CONCLUSIONS
Short-term exposure to ozone was associated with a higher risk of pneumonia at 0-4 years and 5-9 years of age, but not at 10-14 years or 15-19 years of age. Our findings can help identify vulnerable periods, determine the target populations for public health interventions, and establish air pollution standards.
Summary
Korean summary
-어린이와 청소년에서 대기오염물질인 오존에 단기 노출되었을 때 폐렴으로 인한 입원 위험이 증가하는지를 건강보험공단 청구자료를 이용하여 구축한 시계열자료로 분석하였다. -0-4세, 5-9세 군에서는 오존 단기 노출 시 폐렴으로 인한 입원 위험이 증가하였으나 10-14세, 15-19세 군에서는 입원 위험 증가가 관찰되지 않았다.
Key Message
• The effects of ozone levels on hospital admissions for pneumonia were evaluated. • We used quasi-Poisson time-series models and a difference-in-differences method. • Ozone levels increased hospital admissions for pneumonia at ages 0–4 and 5–9 years. • Evidence for the effects of ozone levels on pneumonia was not found at older ages.

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  • Challenges of Air Pollution and Health in East Asia
    Xihao Du, Renjie Chen, Haidong Kan
    Current Environmental Health Reports.2024; 11(2): 89.     CrossRef
  • Intraday exposure to ambient ozone and emergency department visits among children: a case-crossover study in southern China
    Jiahong Ren, Lifeng Zhu, Yachen Li, Haiyi Li, Qian Hu, Jian Zhu, Qingyan Zhang, Yunquan Zhang
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Cohort Profile
Cohort profile: the Ewha Birth and Growth Study
Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Jeong Choi, Ui Jeong Kim, Hyun Jin Park, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eui-Jung Kim, Eun Hee Ha, Hyesook Park
Epidemiol Health. 2021;43:e2021016.   Published online February 22, 2021
DOI: https://doi.org/10.4178/epih.e2021016
  • 12,454 View
  • 406 Download
  • 8 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.
Summary
Korean summary
이화영아성장코호트는 만성질환 예방을 위한 생애초기 위험인자에 대한 근거를 제공하기 위해 2001년에 시작되었습니다. 이화영아성장코호트는 국내에서 선도적인 장기 추적관찰 연구로, 소아기 건강과 관련된 산전 및 출생 시 특징, 소아기 대사와 관련된 유전적 혹은 후성학적 특성, 내분비 장애물질 노출에 따른 영향, 소아기의 식이패턴과 같은 다양한 연구결과들을 발표하였습니다. 추후 청년기의 자료 수집을 계획하고 있으며, 우리의 연구결과는 만성질환 예방을 위한 중재 개발에 기여할 것으로 기대됩니다.
Key Message
To provide evidence of early life risk factors for the prevention of chronic diseases, the Ewha Birth and Growth Study was started in 2001. The Ewha Birth and Growth cohort is a leading long-term follow-up study in Korea, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. We are planning to collect data for early adulthood, and our findings will contribute to the development of interventions to prevent chronic diseases.

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  • Prospective association between phthalate exposure in childhood and liver function in adolescence: the Ewha Birth and Growth Cohort Study
    Seonhwa Lee, Hye Ah Lee, Bohyun Park, Hyejin Han, Young Sun Hong, Eun Hee Ha, Hyesook Park
    Environmental Health.2023;[Epub]     CrossRef
  • BMI trajectory and inflammatory effects on metabolic syndrome in adolescents
    Ui-Jeong Kim, Eun Jeong Choi, Hyunjin Park, Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eun Hee Ha, Seungyoun Jung, Hyesook Park
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  • The Effect of Childhood Obesity or Sarcopenic Obesity on Metabolic Syndrome Risk in Adolescence: The Ewha Birth and Growth Study
    Hyunjin Park, Seunghee Jun, Hye-Ah Lee, Hae Soon Kim, Young Sun Hong, Hyesook Park
    Metabolites.2023; 13(1): 133.     CrossRef
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    Sung Hee Lee, Eun Jeong Choi, Ui Jeong Kim, Hyunjin Park, Bomi Park, Hye Ah Lee, Hyesook Park, Linglin Xie
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Original Articles
Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression
Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Leili Tapak, Iman Dianat, Akram Karimi-Shahanjarini, Rashid Heidarimoghadam
Epidemiol Health. 2020;42:e2020039.   Published online June 2, 2020
DOI: https://doi.org/10.4178/epih.e2020039
  • 12,432 View
  • 281 Download
  • 7 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students.
METHODS
In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used.
RESULTS
In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP.
CONCLUSIONS
A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.
Summary

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  • Cultural appropriateness of interventions to prevent and reduce musculoskeletal disorders among students: a systematic review
    Maryam Afshari, Elham Gheysvandi, Rohollah Norian, Mehdi Kangavari
    Ergonomics.2024; : 1.     CrossRef
  • Prevalence of chronic pain and contributing factors: a cross-sectional population-based study among 2,379 Iranian adolescents
    Maryam Shaygan, Azita Jaberi, Marziehsadat Razavizadegan, Zainab Shayegan
    The Korean Journal of Pain.2023; 36(2): 230.     CrossRef
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    Farzin Bagheri Sheykhangafshe, Hojjatollah Farahani, Mohsen Dehghani, Ali Fathi-Ashtiani
    Journal of Rafsanjan University of Medical Sciences.2023; 22(6): 617.     CrossRef
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    Aina M. Galmés-Panadés, Josep Vidal-Conti
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    Vicente Miñana-Signes, Manuel Monfort-Pañego, Antonio Hans Bosh-Bivià, Matias Noll
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  • Identification of factors related to behaviors associated with musculoskeletal pain among elementary students
    Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Akram Karimi-Shahanjarini, Leili Tapak, Rashid Heidarimoghadam, Iman Dianat
    BMC Musculoskeletal Disorders.2021;[Epub]     CrossRef
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    Dijana Laštro, Mirsad Muftić, Nenad Ponorac, Dubravko Bokonjić
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  • Designing School Tables and Chairs based on Anthropometry of Elementary School Students in Surabaya
    Riska Ayu Yulianingtyas, Dani Nasirul Haqi
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    Massimiliano Polastri, Julie Swann
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  • Effectiveness of mat Pilates on postural alignment in the sagittal plane in school children: a randomized clinical trial
    Fabíola Unbehaun Cibinello, Jessica Caroliny de Jesus Neves, Mônica Yosino Leão Carvalho, Paola Janeiro Valenciano, Dirce Shizuko Fujisawa
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Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study
Mekonen Adimasu, Girum Sebsibie, Fikrtemariam Abebe, Getaneh Baye, Kerebih Abere
Epidemiol Health. 2020;42:e2020003.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020003
  • 14,509 View
  • 401 Download
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AbstractAbstract PDF
Abstract
OBJECTIVES
Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.
METHODS
A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.
RESULTS
The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).
CONCLUSIONS
The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.
Summary

Citations

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  • Stabilizing time and its predictors among 1–59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study
    Wagnew Tesfay, Mebrahtu Abay, Berhane Fseha Teklehaimanot, Ataklti Gebremedhin
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    Seyum Ebissa Eyi, Gebiso Roba Debele, Efrem Negash, Kebebe Bidira, Debela Tarecha, Kabtamu Nigussie, Mohammedamin Hajure, Mohammedjud Hassen Ahmed, Bilisumamulifna Tefera Kefeni
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    Abdullah-Al Mamun, Shuva Bhowmik, Md. Shahid Sarwar, Sharmin Akter, Tanjina Pias, MUM Abu Zakaria, Md. Monirul Islam, Hillary Egna, Ford Evans, Md Abdul Wahab, Shakuntala Haraksingh Thilsted, David C. Little
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Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?
Elham Khatooni, Isa Akbarzadeh, Elham Abdalmaleki, Zhaleh Abdi, Elham Ahmadnezhad
Epidemiol Health. 2019;41:e2019045.   Published online October 11, 2019
DOI: https://doi.org/10.4178/epih.e2019045
  • 11,108 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.
METHODS
This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.
RESULTS
Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.
CONCLUSIONS
Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.
Summary

Citations

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  • Iranian women's birth experiences: a cross-sectional study
    Mona Ghobadi, Farzaneh Pazandeh, Barbara Potrata, Ehsan Kazemnejad Lili
    British Journal of Midwifery.2022; 30(12): 685.     CrossRef
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    Yasmin Madani-Lavassani
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The relationship between maternal mental health and communication skills in children in Shiraz, Iran
Najmeh Maharlouei, Hossein Alibeigi, Abbas Rezaianzadeh, Pedram Keshavarz, Hadi Raeisi Shahraki, Hamid Nemati, Kamran B. lankarani
Epidemiol Health. 2019;41:e2019035.   Published online July 19, 2019
DOI: https://doi.org/10.4178/epih.e2019035
  • 13,080 View
  • 238 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children.
METHODS
This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children.
RESULTS
The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01).
CONCLUSIONS
The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.
Summary

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  • Prevalence and Risk Factors Associated With Self-reported Psychological Distress Among Children and Adolescents During the COVID-19 Pandemic in China
    Zuguo Qin, Lei Shi, Yaqing Xue, Huang Lin, Jinchan Zhang, Pengyan Liang, Zhiwei Lu, Mengxiong Wu, Yaguang Chen, Xiao Zheng, Yi Qian, Ping Ouyang, Ruibin Zhang, Xuefeng Yi, Chichen Zhang
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    Kathryn Mishkin, Shaymaa Samir Maqsood, Hamdia Mirkhan Ahmed
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    Najmeh Maharlouei, Sogand Farhangian, Hadi Raeisi Shahraki, Abbas Rezaianzadeh, Kamran Bagheri Lankarani
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