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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
  • 1,153 View
  • 134 Download
AbstractAbstract AbstractSummary 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.
Postpartum Depression in Young Mothers in Urban and Rural Indonesia
Alifa Syamantha Putri, Tri Wurisastuti, Indri Yunita Suryaputri, Rofingatul Mubasyiroh
J Prev Med Public Health. 2023;56(3):272-281.   Published online May 7, 2023
DOI: https://doi.org/10.3961/jpmph.22.534
  • 2,037 View
  • 141 Download
  • 1 Crossref
AbstractAbstract PDF
Objectives
Young mothers are vulnerable to postpartum depression due to role transition-related stress. Understanding the causes underlying these stressors is essential for developing effective interventions.
Methods
This study analyzed the 2018 Indonesian Basic Health Research data. The Mini International Neuropsychiatric Interview was used to assess postpartum depression symptoms in mothers aged 15-24 years with infants aged 0-6 months. In 1285 subjects, the risk factors for postpartum depression were evaluated using multivariate logistic regression.
Results
The overall prevalence of depression in the 6 months postpartum was 4.0%, with a higher prevalence in urban areas (5.7%) than in rural areas (2.9%). Urban and rural young mothers showed distinct postpartum depression risk factors. In urban areas, living without a husband (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.24 to 11.76), experiencing preterm birth (OR, 4.67; 95% CI, 1.50 to 14.50), having pregnancy complications (OR, 3.03; 95% CI, 1.20 to 7.66), and having postpartum complications (OR, 5.23; 95% CI, 1.98 to 13.80) were associated with a higher risk of postpartum depression. In rural areas, postpartum depression was significantly associated with a smaller household size (OR, 3.22; 95% CI, 1.00 to 10.38), unwanted pregnancy (OR, 4.40; 95% CI, 1.15 to 16.86), and pregnancy complications (OR, 3.41; 95% CI, 1.31 to 8.88).
Conclusions
In both urban and rural contexts, postpartum depression relates to the availability of others to accompany young mothers throughout the postpartum period and offer support with reproductive issues. Support from the family and the healthcare system is essential to young mothers’ mental health. The healthcare system needs to involve families to support young mothers’ mental health from pregnancy until the postpartum period.
Summary

Citations

Citations to this article as recorded by  
  • Qualitative Study of Perinatal Mental Health Services: Experiences and Perspectives of Health Workers and Patients
    Evi Diliana Rospia, Dwi Kartika Cahyaningtyas, Siti Mardiyah WD, Cahaya Indah Lestari
    EMBRIO.2023; 15(2): 216.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health