BACKGROUND

Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.

The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital.

A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.

Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.

This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.

Becoming a mother represents a pivotal life transition that introduces new roles and responsibilities for women. A deeper understanding of this concept can aid researchers and healthcare professionals in selecting appropriate measurement tools and designing nursing interventions that support a positive transition to motherhood, particularly for first-time mothers. This concept analysis aimed to explore and to clarify the defining attributes of maternal role transition in first pregnancy in order to establish an operational definition, and to identify its antecedents and consequences.

Guided by Walker and Avant's concept analysis model, this study also applied the Population, Concept, and Context (PCC) framework to determine eligibility criteria for the integrative review: studies on motherhood (population), transition (concept), and first-time pregnancy and childbirth (context). Electronic databases including CINAHL, MEDLINE, Scopus, and ProQuest were searched. Extracted data included definitions of maternal role transition, its key domains, the settings and populations of the included studies, and information relevant to the eight steps of concept analysis—namely, attributes, antecedents, and consequences.

From an initial 1,045 citations, 64 full-text articles were screened, and 30 studies met the inclusion criteria. Findings indicated that maternal role transition is both a process and an experience that facilitates a woman's journey toward embracing motherhood. Influential factors include preparation, perceived life changes, social support, trust, emotional comfort, couple relationships, and infant growth and development. A successful transition resulted in enhanced maternal skills, competence, confidence, acceptance of the maternal role, gratification, infant attachment, and overall maternal role adjustment.

Human ; Mass Screening ; Mothers ; Nuchal Translucency Measurement ; Prenatal Diagnosis

Background: Child-rearing is challenging for adolescent mothers at risk of providing limited care to their children because of the challenges and demands of simultaneously being an adolescent and a mother. Children aged 0-2 years depend on caregivers like their young mothers to promote their physical, emotional, social, and cognitive growth and development. Objective: The study aimed to determine the effectiveness of the Child-rearing Information Booklet (CRIB) among adolescent mothers with children aged 0-2 years on the three dimensions of knowledge, attitude, and practices. Methods: The study utilized the quasi-experimental non-equivalent pre-test-post-test control group design to investigate 30 intervention and 30 comparison adolescent mothers with children aged 0-2 years who met the study criteria in Baguio City from January 2019 to January 2021. The fishbowl sampling technique was used in selecting the population and the specific barangays. A validated self-made questionnaire (I-CVI of 0.95 with Cronbach's α of 0.96) determined both groups' knowledge, attitude, and practices (KAP). The study used the weighted mean for adolescent mothers' KAP while an independent sample t-test analyzed the significant change in the scores of both groups and to answer the significant difference in the pre- and post-test scores between the two groups. Results: The results revealed that both groups are knowledgeable about child-rearing skills. Both groups have a favorable attitude when caring for their children and have a very satisfactory practice in childcare. The study also yielded a significant difference in the change of scores in the pre-and post-test scores of the two groups, specifically in knowledge and practice, while no significant difference in their attitude. It also presented a significant difference in the post-test scores between the two groups along with their knowledge (large effect size), attitude (medium effect size), and practices (large effect size). Conclusions Adolescent mothers have pre-existing KAP in child-rearing. The CRIB effectively enhances adolescent mothers' child-rearing knowledge and practice. Also, the increase of scores in KAP in child-rearing during the posttest may not be solely caused by the CRIB but also influenced by their age, level of education, living environment, experience in child-rearing, and age of their child. The CRIB has a high practical significance in improving the knowledge and practices among adolescent mothers but not in their attitude.
Adolescent Mothers ; Knowledge ; Attitude

BACKGROUND

Child-rearing is challenging for adolescent mothers at risk of providing limited care to their children because of the challenges and demands of simultaneously being an adolescent and a mother. Children aged 0-2 years depend on caregivers like their young mothers to promote their physical, emotional, social, and cognitive growth and development.

The study aimed to determine the effectiveness of the Child-rearing Information Booklet (CRIB) among adolescent mothers with children aged 0-2 years on the three dimensions of knowledge, attitude, and practices.

The study utilized the quasi-experimental non-equivalent pre-test-post-test control group design to investigate 30 intervention and 30 comparison adolescent mothers with children aged 0-2 years who met the study criteria in Baguio City from January 2019 to January 2021. The fishbowl sampling technique was used in selecting the population and the specific barangays. A validated self-made questionnaire (I-CVI of 0.95 with Cronbach's α of 0.96) determined both groups' knowledge, attitude, and practices (KAP). The study used the weighted mean for adolescent mothers' KAP while an independent sample t-test analyzed the significant change in the scores of both groups and to answer the significant difference in the pre- and post-test scores between the two groups.

The results revealed that both groups are knowledgeable about child-rearing skills. Both groups have a favorable attitude when caring for their children and have a very satisfactory practice in childcare. The study also yielded a significant difference in the change of scores in the pre-and post-test scores of the two groups, specifically in knowledge and practice, while no significant difference in their attitude. It also presented a significant difference in the post-test scores between the two groups along with their knowledge (large effect size), attitude (medium effect size), and practices (large effect size).

Adolescent mothers have pre-existing KAP in child-rearing. The CRIB effectively enhances adolescent mothers' child-rearing knowledge and practice. Also, the increase of scores in KAP in child-rearing during the posttest may not be solely caused by the CRIB but also influenced by their age, level of education, living environment, experience in child-rearing, and age of their child. The CRIB has a high practical significance in improving the knowledge and practices among adolescent mothers but not in their attitude.

Objective: To investigate the association between screen exposure and language skills in children aged 2-5 years. Methods: There were 299 children aged 2-5 years, recruited by convenience sampling from those who visited the Center of Children's Healthcare, Children's Hospital, Capital Institute of Pediatrics for routine physical examination from November 2020 to November 2021. Their development status were evaluated by the children neuropsychological and behavioral scale (revision 2016). A self-designed questionnaire for parents was conducted to collect demographic and socioeconomic information and screen exposure characteristics (time and quality). One-way ANOVA and independent sample t test were applied to compare the differences in language development quotient of children with different screen exposure time and quality. Multiple linear regression was used to analyze the correlation between screen exposure time and quality with language developmental quotient. Multivariate Logistic regression was used to analyze the risk of language underdevelopment in children with different screen exposure time and quality. Results: Among 299 children, 184 (61.5%) were boys and 115 (38.5%) were girls, with the age of (3.9±1.1) years. The number of children with daily screen time <60, 60-120 and>120 min was 163 children (54.5%), 86 children (28.8%) and 50 children (16.7%), respectively, with the language development quotients of 94±13, 90±13, 84±14, respectively, demonstrating a statistically significant difference (F=8.92, P<0.001). Logistic regression analysis revealed that screen exposure time of 60-120 and >120 min per day were both risk factors for children's language developmental quotients (OR=2.28, 95%CI 1.00-5.17, P=0.043; OR=3.96, 95%CI 1.86-9.17, P<0.001), and co-viewing and exposure to educational programs were both protective factors for children's language developmental quotients (OR=0.48, 95%CI 0.25-0.91, P=0.024, OR=0.36, 95%CI 0.19-0.70, P=0.003). Conclusions: Excessive exposure screen time and inappropriate screen exposure habits are associated with children's poorer language development. Screen exposure time should be limited and screen use should be rational to promote children's language skills.
Male ; Female ; Humans ; Child ; Surveys and Questionnaires ; Parents/psychology* ; Cognition ; Risk Factors

OBJECTIVE: To analyze the clinical phenotype and genetic variants of a child suspected for mitochondrial F-S disease. METHODS: A child with mitochondrial F-S disease who visited Department of Neurology, Hunan Provincial children's Hospital on November 5, 2020 was selected as research subject of this study. Clinical data of the child was collected. The child was subjected to whole exome sequencing (WES). Bioinformatics tools were used to analyze the pathogenic variants. Candidate variants were verified by Sanger sequencing of the child and her parents. RESULTS: WES revealed that the child has harbored compound heterozygous variants of the FDXR gene, namely c.310C>T (p.R104C) and c.235C>T (p.R79C), which were inherited from her father and mother, respectively. Neither variant has been reported in HGMD, PubMed, 1000 Genomes, and dbSNP databases. Both of the variants have been suggested as deleterious according to the prediction results from different bioinformatics analysis software. CONCLUSION Mitochondrial diseases should be suspected for patients with multiple system involvement. The compound heterozygous variants of the FDXR gene probably underlay the disease in this child. Above finding has enriched the spectrum of FDXR gene mutations underlying mitochondrial F-S disease. WES can facilitate the diagnosis of mitochondrial F-S disease at the molecular level.
Female ; Humans ; Exome Sequencing ; Mitochondrial Diseases/genetics* ; Mothers ; Mutation ; Phenotype ; Child

Humans ; Child ; Cross-Sectional Studies ; Singapore ; Neoplasms/psychology* ; Adaptation, Psychological ; Parents/psychology*

Humans ; Child ; SARS-CoV-2 ; Viral Load ; COVID-19 ; Parents

Objective:By analyzing the clinical phenotypic characteristics and gene sequences of two patients with Treacher Collins syndrome（TCS）, the biological causes of the disease were determined. Then discuss the therapeutic effect of hearing intervention after bone bridge implantation. Methods:All clinical data of the two family members were collected, and the patients signed the informed consent. The peripheral blood of the proband and family members was extracted, DNA was extracted for whole exome sequencing, and Sanger sequencing was performed on the family members for the mutation site.TCOF1genetic mutations analysis was performed on the paitents. Then, the hearing threshold and speech recognition rate of family 2 proband were evaluated and compared under the sound field between bare ear and wearing bone bridge. Results:In the two pedigrees, the probands of both families presented with auricle deformity, zygomatic and mandibular hypoplasia, micrognathia, hypotropia of the eye fissure, and hypoplasia of the medial eyelashes. The proband of Family 1 also presents with specific features including right-sided narrow anterior nasal aperture and dental hypoplasia, which were consistent with the clinical diagnosis of Treacher Collins syndrome. Genetic testing was conducted on both families, and two heterozygous mutations were identified in the TCOF1 gene: c. 1350_1351dupGG（p. A451Gfs*43） and c. 4362_4366del（p. K1457Efs*12）, resulting in frameshift mutations in the amino acid sequence. Sanger sequencing validation of the TCOF1 gene in the parents of the proband in Family 1 did not detect any mutations. Proband 1 TCOF1 c. 1350_1351dupGG heterozygous variants have not been reported previously. The postoperative monosyllabic speech recognition rate of family 2 proband was 76%, the Categories of Auditory Performance（CAP） score was 6, and the Speech Intelligibility Rating（SIR） score was 4. Assessment using the Meaningful Auditory Integration Scale（MAIS） showed notable improvement in the patient's auditory perception, comprehension, and usage of hearing aids. Evaluation using the Glasgow Children's Benefit Inventory and quality of life assessment revealed significant improvements in the child's self care abilities, daily living and learning, social interactions, and psychological well being, as perceived by the parents. Conclusion:This study has elucidated the biological cause of Treacher Collins syndrome, enriched the spectrum of TCOF1 gene mutations in the Chinese population, and demonstrated that bone bridge implantation can improve the auditory and speech recognition rates in TCS patients.
Child ; Humans ; Mandibulofacial Dysostosis/genetics* ; Quality of Life ; Speech ; Parents ; Mutation ; Nuclear Proteins/genetics* ; Phosphoproteins/genetics*