Journal of Preventive Medicine and Public Health

Original Articles

Correlations Among Maternal and Infant Factors, Lead Exposure, and Serum Prolactin Levels During Lactation: A Cross-sectional Study in Indonesia: Linda Ratna Wati, Djanggan Sargowo, Tatit Nurseta, Lilik Zuhriyah, Bambang Rahardjo; J Prev Med Public Health. 2023;56(5):422-430. Published online August 22, 2023; DOI: https://doi.org/10.3961/jpmph.23.238

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Abstract Summary PDF: Objectives
Prolactin is vital for breastfeeding and milk production, and its secretion is influenced by factors related to the mother, infant, and environment. To date, no study has concurrently investigated the correlation of these factors with serum prolactin levels during lactation. Therefore, the objective of this study was to investigate the correlations among maternal and infant factors, lead exposure, and serum prolactin levels during lactation.
Methods
A cross-sectional approach was employed in Surabaya, Indonesia, among 110 exclusively lactating mothers. The mothers’ daily diets were determined using multiple 24-hour recalls, while blood lead levels were measured with inductively coupled plasma mass spectrometry. Serum prolactin levels were assessed using the electrochemiluminescence immunoassay. For bivariate analysis, we employed the Spearman correlation, Mann-Whitney, and Kruskal-Wallis tests, while for multivariate analysis, we utilized multiple linear regression.
Results
The average serum prolactin level of the lactating mothers was 129.19±88.96 ng/mL. Positive correlations were found between serum prolactin levels and breastfeeding frequency (p < 0.001), protein intake (p < 0.001), and calcium intake (p = 0.011) but had negative correlation with blood lead levels (p < 0.001) and vitamin B6 intake (p = 0.003). Additionally, prolactin levels were not significantly associated with maternal age; parity; intake of calories, vitamin D, vitamin E, zinc, folic acid, magnesium, or iron; infant age; or infant sex.
Conclusions
Breastfeeding frequency had a stronger positive relationship with serum prolactin levels than protein and calcium intake. However, lead exposure was associated with reduced serum prolactin levels during lactation. Consequently, specific interventions from policymakers are necessary to manage breastfeeding in mothers exposed to lead.; Summary

Key Message
Prolactin secretion is influenced by factors related to the mother, infant, and environment, and this study was to investigate the correlations among maternal and infant factors, lead exposure, and serum prolactin levels during lactation. In total 110 exclusively lactating mothers were included, with information on their socio-demographic, daily diet, blood lead level, prolactin level, and infant characteristics. Breastfeeding frequency had a stronger positive relationship with serum prolactin levels than protein and calcium intake. However, lead exposure was associated with reduced serum prolactin levels during lactation. Consequently, specific interventions from policymakers are necessary to manage breastfeeding in mothers exposed to lead.

Adverse Events Following Immunizations in Infants Under 1 Year of Age in Lorestan Province, Western Iran: Anbari khatereh, Ghanadi Koruosh, Toulabipour Alireza, Jamebozuorghi Daryuosh, Baharvand Parastoo; J Prev Med Public Health. 2023;56(2):172-179. Published online March 14, 2023; DOI: https://doi.org/10.3961/jpmph.22.540

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Abstract PDF: Objectives
Vaccination is an important intervention for preventing disease and reducing disease severity. Universal vaccination programs have significantly reduced the incidence of many dangerous diseases among children worldwide. This study investigated the side effects after immunization in infants under 1 year of age in Lorestan Province, western Iran.
Methods
This descriptive analytical study included data from all children <1 year old in Lorestan Province, Iran who were vaccinated according to the national schedule in 2020 and had an adverse event following immunization (AEFI). Data were extracted from 1084 forms on age, sex, birth weight, type of birth, AEFI type, vaccine type, and time of vaccination. Descriptive statistics (frequency, percentage) were calculated, and the chi-square test and Fisher exact test were used to assess differences in AEFIs according to the abovelisted variables.
Results
The most frequent AEFIs were high fever (n=386, 35.6%), mild local reaction (n=341, 31.5%), and swelling and pain (n=121, 11.2%). The least common AEFIs were encephalitis (n=1, 0.1%), convulsion (n=2, 0.2%), and nodules (n=3, 0.3%). Girls and boys only showed significant differences in mild local reactions (p=0.044) and skin allergies (p=0.002). The incidence of lymphadenitis (p<0.001), severe local reaction (p<0.001), mild local reaction (p=0.007), fainting (p=0.032), swelling and pain (p=0.006), high fever (p=0.005), and nodules (p<0.001) showed significant differences based on age at vaccination.
Conclusions
Immunization is a fundamental public health policy for controlling vaccine-preventable infectious diseases. Although vaccines such as the Bacillus Calmette-Guérin vaccine, oral poliovirus vaccine, and pentavalent vaccine are well-researched and reliable, AEFIs are inevitable.; Summary

Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries: Miftahul Arsyi, Besral Besral, Milla Herdayati, Revati Phalkey; J Prev Med Public Health. 2022;55(6):559-567. Published online November 13, 2022; DOI: https://doi.org/10.3961/jpmph.22.316

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Abstract PDF Supplementary Material

Objectives
This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN).
Methods
Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017.
Results
The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers’ demographic/socioeconomic factors, health behaviors, and other factors.
Conclusions
In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.

Summary

Citations

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Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries
Vishnu Khanal, Sangita Bista, Shiva Raj Mishra
BMC Public Health.2024;[Epub] CrossRef
Effect of the enhancing nutrition and antenatal infection treatment (ENAT) intervention on birth weight in Ethiopia: a cluster randomized controlled trial
Y Mekonnen, E Wolde, A Bekele, Z Mehari, S Abebe, T Hagos, Y Tadesse, T Taye, G Asire, T Nigatu, S Kumar, S Girma, M Salasibew
BMC Pregnancy and Childbirth.2023;[Epub] CrossRef
Compliance with the World Health Organization’s 2016 prenatal care contact recommendation reduces the incidence rate of adverse birth outcomes among pregnant women in northern Ghana
Leticia Achangebe Akum, Eunice Amina Offei, Mary Rachael Kpordoxah, Daudi Yeboah, Abdul-Nasir Issah, Michael Boah, Sanjoy Kumer Dey
PLOS ONE.2023; 18(6): e0285621. CrossRef

Impact of Changes in Maternal Age and Parity Distribution on the Increasing Trends in the Low Birth Weight and Very Low Birth Weight Rates in South Korea, 2005-2015: Yujin Oh, Jisuk Bae; J Prev Med Public Health. 2019;52(2):123-130. Published online March 14, 2019; DOI: https://doi.org/10.3961/jpmph.18.247

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Abstract Summary PDF

Objectives
The aim of this study was to evaluate the impact of shifts in maternal age and parity on the increasing trends in the low birth weight (LBW) and very low birth weight (VLBW) rates from 2005 to 2015 in South Korea.
Methods
Data from 4 993 041 live births registered with Statistics Korea during the period between 2005 and 2015 were analyzed. Applying a modified standardization method, we partitioned the total increment in the LBW and VLBW rates into (1) the increase in the LBW and VLBW rates due to changes in the maternal age and parity distribution (AP-dis) and (2) the increase due to changes in the age-specific and parity-specific rates (AP-spe) of LBW and VLBW for singleton and multiple births, respectively.
Results
During the study period, the total increment in the LBW and VLBW rates was 1.43%p and 0.25%p, respectively. Among singleton births, changes in the AP-dis accounted for 79% (0.34%p) and 50% (0.06%p) of the total increment in the LBW and VLBW rates, respectively. Meanwhile, among multiple births, changes in the AP-dis did not contribute to the increase in the LBW and VLBW rates, with 100% of the increase in the LBW (1.00%p) and VLBW (0.13%p) rates being attributed to changes in the AP-spe.
Conclusions
This study demonstrated that shifts in maternal age and parity were prominent contributors to the increase in the LBW and VLBW rates among singleton births between 2005 and 2015 in South Korea.

Summary

Korean summary
우리나라 출생자료를 이용하여 2005년부터 2015년까지 한국인 저출생체중아 및 극소저출생체중아 발생률 증가에서 1) 산모연령 및 출산순위 분포변화에 기인하는 부분과 2) 이들 분포변화 이외의 요인에 기인하는 부분을 수정된 표준화법을 적용하여 평가하였다. 분석 결과, 단태아에서 저출생체중아 발생률 증가량의 79% (0.34%p), 극소저출생체중아 발생률 증가량의 50% (0.06%p)가 산모연령 및 출산순위 분포변화에 기인한 것으로 나타났다. 반면, 다태아에서는 저출생체중아 및 극소저출생체중아 발생률 증가량의 100% (저출생체중아 1.00%p, 극소저출생체중아 0.13%p)가 이들 분포변화 이외의 요인에 기인한 것으로 나타났다.

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Birth weight following pregnancy wildfire smoke exposure in more than 1.5 million newborns in Brazil: A nationwide case-control study
Weeberb J. Requia, Heresh Amini, Matthew D. Adams, Joel D. Schwartz
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Molecular Psychiatry.2022; 27(10): 4172. CrossRef
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Fatimah H. Dallak, Ibrahim M. Gosadi, Wejdan N. Haidar, Amjad A. Durayb, Abeer R. Alomaish, Atheer H. Alshamakhi, Raoud M. Khormi, Ali H. Almudeer, Majed A. Alibrahim
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Journal of Epidemiology.2021; 31(6): 392. CrossRef
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Yoo-Na Kim, Dong-Woo Choi, Dong Seop Kim, Eun-Cheol Park, Ja-Young Kwon
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Modeling the Effect of Mother's Characteristics on the Weight of a Newborn
Oluwafemi Samson Balogun, Donald Douglas Atsa'am, Toluwalase Janet Akingbade, Emmanuel Awuni Kolog, Richard O. Agjei, Samuel Nii Odoi Devine
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Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014): Pouran Raeissi, Touraj Harati-Khalilabad, Aziz Rezapour, Seyed Yaser Hashemi, Abdoreza Mousavi, Saeed Khodabakhshzadeh; J Prev Med Public Health. 2018;51(3):140-147. Published online May 14, 2018; DOI: https://doi.org/10.3961/jpmph.17.153

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Abstract PDF

Objectives
Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures.
Methods
This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships.
Results
Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term.
Conclusions
The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.

Summary

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Changes in the Distribution of Maternal Age and Parity and Increasing Trends in the Low Birth Weight Rate in Korea Between 1995 and 2005: Jisuk Bae, Jung Han Park, Yoo Keun Park, Jong-Yeon Kim, Sang-Won Lee, Soon-Woo Park; J Prev Med Public Health. 2011;44(3):111-117. Published online May 17, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.3.111

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Abstract PDF

Objectives

This study measured the impact of shifts in maternal age and parity on the increase in the low birth weight (LBW) rate in Korea.

Methods

We obtained raw data for all 6 397 945 live births registered at the Korea National Statistical Office between 1995 and 2005. We calculated the proportion of increment in the LBW rate due to changes in the distribution of maternal age and parity (AP-dis) and the proportion due to changes in the age- and parity-specific LBW rate (AP-spe).

Results

The LBW rate increased from 3.02% in 1995 to 4.28% in 2005. The multiple birth rate increased from 1.32% to 2.19% during the same period. Of the 1.26% points increment in the LBW rate, 0.64% points occurred among singleton births and 0.62% points occurred among multiple births. Changes in the AP-dis accounted for 50% of the increase in the LBW rate among singleton births, but did not contribute to the increase in the LBW rate among multiple births. The remainder of the total increment in the LBW rate was explained by the increase in the AP-spe.

Conclusions

This study demonstrated that shifts in maternal age and parity among singleton births and increased multiple births were important contributors to the increment in the LBW rate. This study also revealed that the increase in the AP-spe was an equally important contributor as the shifts in maternal age and parity to the increment in the LBW rate among singleton births and was a major contributor among multiple births.

Summary

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International Journal of Childbirth.2020; 10(4): 206. CrossRef
Impact of Changes in Maternal Age and Parity Distribution on the Increasing Trends in the Low Birth Weight and Very Low Birth Weight Rates in South Korea, 2005-2015
Yujin Oh, Jisuk Bae
Journal of Preventive Medicine and Public Health.2019; 52(2): 123. CrossRef
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Vahid Rahmanian, Yaser Sarikhani, Keramatollah Rahmanian, Elham Mansoorian, Mahdieh Zare
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Myunghee Jun, Vipavee Thongpriwan, Kyung Sook Choi
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Maternal Exposure to Environmental Tobacco Smoke (ETS) and Pregnancy Outcome (low birth weight or preterm baby) in Prospective Cohort Study.: Bo Eun Lee, Yun Chul Hong, Hye Sook Park, Jong Tae Lee, Jeong Youn Kim, Young Joo Kim, Sang Hyun Kim, Kang Jung Goo, Joo Oh Kim, Eun Hee Ha; Korean J Prev Med. 2003;36(2):117-124.

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Abstract PDF: OBJECTIVES
This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preterm baby) in a prospective cohort study. METHODS: We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2, 250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1, 712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preterm or low birth weight, and a linear regression analysis for the birth weight and gestational age. RESULTS: Higher exposure to ETS (> or =1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1hour). Maternal exposure to ETS was associated with preterm baby (adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. CONCLUSIONS: This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preterm births.; Summary

Cohort Infant Mortality Rate of Gunwee and Hapchun Counties and an MCH Center in Taegu.: Jung Han Park, Min Hae Yeh, Byung Yeol Chun, Sung Euk Cho, Hyun Kim, Han Jin Chung, Jae Yeon Cho, Jung Hub Song, Gui Yeon Kim, Jang Rak Kim; Korean J Prev Med. 1990;23(1):87-97.

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Abstract PDF: No abstract available.; Summary

English Abstract

The Effects of the Parents' Social Class on Infant and Child Death among 1995-2004 Birth Cohort in Korea.: Mia Son, Juhwan Oh, Yong Jun Choi, Jeong Ok Kong, Jisook Choi, Eunjeong Jin, Sung Tae Jung, Se Jin Park; J Prev Med Public Health. 2006;39(6):469-476.

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Abstract PDF: OBJECTIVES
To investigate the effect of parents' social class on infant and child mortality rates among the birth cohort, for the period of transition to and from the Koran economic crisis 1995-2004. METHODS: All births reported to between 1995 and 2004 (n=5,711,337) were analyzed using a Cox regression model, to study the role of the social determinants of parents in infant and child mortality. The results were adjusted for the parents' age, education and occupation, together with mother's obstetrical history. RESULTS: The crude death rate among those under 10 was 3.71 per 1000 births (21,217 deaths among 5,711,337 births) between 1995 and 2004. The birth cohorts from lower educated parents less than elementary school showed higher mortality rates compared with those from higher educated parents over university level (HR:3.0 (95%CI:2.8-3.7) for father and HR:3.4 (95%CI:3.3-4.5) for mother). The mother's education level showed a stronger relationship with mortality among the birth cohort than that of the fathers'. The gaps in infant mortality rates by parents' social class, and educational level became wider from 1995 to 2004. In particular, the breadth of the existing gap between higher and lower parents' social class groups has dramatically widened since the economic crisis of 1998. DISCUSSIONS: This study shows that social differences exist in infant and child mortality rates. Also, the gap for the infant mortality due to social class has become wider since the economic crisis of 1998.; Summary

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