BACKGROUND: Although the clinical importance of the immunological benefits of breastfeeding has been emphasized for decades, their direct relationship with acute pyelonephritis (APN) is still not clear. Our goal was to determine whether breastfeeding truly provides protection against APNs, while investigating the effects of other factors such as sex, age, mode of delivery, and birth weight on APN.METHODS: A total of 62 infants under 6 months of age who had both microbiologically and radiologically-confirmed APN were enrolled in the case group. Healthy infants (n = 178) who visited the hospital for scheduled vaccinations were enrolled in the control group. The following participant characteristics were compared between the case and control groups: age, sex, birth order among siblings, feeding methods, weight percentile by month, birth weight percentile by gestational age, gestational age at birth, and mode of delivery.RESULTS: Babies exclusively fed with manufactured infant formulae before 6 months of age had significantly higher risk for APN than breastfed or mixed-fed infants (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.687–7.031; P = 0.001). Firstborn babies had lower risk for APN than 2nd- or 3rd-born babies (OR, 0.43; 95% CI, 0.210–0.919). Other factors that increased the risk for APN were low birth weight percentiles (OR, 8.33; 95% CI, 2.300–30.166) and birth via caesarean section (OR, 2.32; 95% CI, 1.097–4.887). There were more preterm births in the case group (10.9% vs. 1.7%; P = 0.002), but this did not increase the risk for APN (OR, 4.47; P = 0.063).CONCLUSION: Feeding exclusively with formula before 6 months of age was related to higher risk for APN, which demonstrates that breastfeeding has a protective effect against APN. The other risk factors for APN were birth order (≥ 2nd-born), low birth weight, and birth via caesarean section.
Birth Order ; Birth Weight ; Breast Feeding ; Cesarean Section ; Feeding Methods ; Female ; Gestational Age ; Humans ; Infant Formula ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Parturition ; Pregnancy ; Premature Birth ; Pyelonephritis ; Reproductive History ; Risk Factors ; Siblings ; Urinary Tract Infections ; Vaccination

PURPOSE: Interleukin-1 beta (IL-1β), a pro-inflammatory cytokine, has been shown to influence breast cancer susceptibility. The relationship between its risk of breast cancer and IL-1β-C31T polymorphism has been demonstrated, but the results remain controversial. Therefore, our study aimed to investigate the correlation between the IL-1β-C31T gene polymorphism and susceptibility to breast cancer. METHODS: The genotype frequencies of IL-1β-C31T polymorphism were compared between 204 breast cancer cases and 210 controls using polymerase chain reaction and restriction fragment length polymorphism techinques. Further multivariate binary logistic regression analyses were used to assess the association between IL-1β-C31T polymorphism and breast cancer risk. RESULTS: The frequency of the T allele of IL-1β-C31T polymorphism in breast cancer cases was significantly higher than that in the controls (56.1% vs. 47.9%). The frequencies of genotypes CC, CT, and TT in the cases were 22.1%, 43.6%, and 34.3%, respectively, while in the control group they were 24.3%, 55.7%, and 20.0%, respectively. There was a significant difference between the prevalence of TT genotype in the 2 groups (adjusted odds ratio [OR], 2.06; 95% confidence interval [CI], 1.16–3.66; p  =  0.014). Breast cancer risk increased in women with TT genotype, body mass index (BMI) ≥ 25 kg/m2 (OR, 2.19; 95% CI, 1.09–4.36), late age at first birth (OR, 2.43; 95% CI, 1.29–4.56), postmenopausal status (OR, 3.15; 95% CI, 1.39–7.16), and negative smoking history (OR, 2.52; 95% CI, 1.32–4.82). Furthermore, increase in breast cancer risk among women diagnosed with invasive ductal carcinoma was associated with CT/TT genotypes (OR, 2.82; 95% CI, 1.38–5.76). CONCLUSION: The IL-1β-C31T polymorphism affects breast cancer susceptibility, especially in women with late age at first birth, high BMI, postmenopausal status, negative smoking history, and invasive ductal carcinoma. Our study adds to the evidence about the importance of IL-1β-C31T polymorphism in breast cancer susceptibility.
Alleles ; Birth Order ; Body Mass Index ; Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Interleukin-1beta ; Logistic Models ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Prevalence ; Smoke ; Smoking

BACKGROUND: This study was conducted to explore the effect of known risk factors, focusing on risk factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, in consideration of interaction among East-Asian women. METHODS: Case-control study with 2,123 cases and 2,121 controls with mammographic density was conducted. Using the mammographic film, breast density was measured using Breast Imaging-Reporting and Data System. To identify the association of selected reproductive factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, stratified analysis was conducted according to breast density groups and interaction effects was assessed. The results were presented with adjusted OR and 95% CIs. RESULTS: Significant interaction effect between age at first birth and breast density on breast cancer (P = 0.048) was observed. Women with age at first birth ≥ 28 years old showed increased breast cancer risk in extremely dense breast group (≥ 75%) (OR = 1.627, 95% CI = 1.190–2.226). However, women with fatty breast (< 50%) and heterogeneously dense breast (50%–75%) did not show an increased association. Age at menarche, age at menopause, number of children, and family history of breast cancer did not show significant interaction with breast cancer and similar risk patterns were observed. CONCLUSIONS: Age at first birth showed significant interaction with breast density on breast cancer risk. Further studies considering biologically plausable model between exposure, intermediate outcomes and breast cancer risk with prospective design need to be undertaken in East Asian women.
Asian Continental Ancestry Group ; Birth Order ; Breast Neoplasms ; Breast ; Case-Control Studies ; Child ; Female ; Humans ; Information Systems ; Menarche ; Menopause ; Prospective Studies ; Reproductive History ; Risk Factors

PURPOSE: The vaccination level of rotavirus vaccine not supported by the government is not known. As vaccines not included in the national immunization schedule are not registered in the computerized national immunization registry system, their vaccination rate cannot be calculated according to the same method used in government-supported vaccines. Therefore, this study aimed to measure the status of the vaccination rate of rotavirus not included in the national immunization schedule. METHODS: The target population is the 0-year-old cohort. The survey population was composed of registered children born in 2017 enrolled in the Immunization Registry Information System. The survey was conducted through a computerized telephone survey method. The survey variables were as follows: vaccination order and date, provider, and data source. Factors related to complete vaccination were the child's sex, residence, birth order, and parents' age, educational level, and job status. RESULTS: Children's vaccination rates for the rotavirus vaccine by 2017 were 88.0%, 86.9%, and 96.6% for the first, second, and third doses, respectively. The rate of complete vaccination was 85.6%. The factors related to rotavirus complete vaccination were the child's sex and birth order, area of residence, parents' age and job status, and father's education level. CONCLUSION: In the future, it is necessary to conduct regular investigations on the rate of rotavirus vaccination as a tool for the development of the rotavirus infectious diseases control policy or as an evaluation tool for vaccine programs.
Birth Order ; Child ; Cohort Studies ; Communicable Diseases ; Education ; Health Services Needs and Demand ; Humans ; Immunization ; Immunization Schedule ; Information Storage and Retrieval ; Information Systems ; Methods ; Rotavirus ; Surveys and Questionnaires ; Telephone ; Vaccination ; Vaccines

BACKGROUND/OBJECTIVES: The 6–23 months for infants is the longest period in the “first 1,000 days” of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6–23 months. SUBJECTS/METHODS: For this cross-sectional study, 392 children aged 6–23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used. RESULTS: Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting. CONCLUSIONS: Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6–23 months old in Aceh. These results highlight the need to improve CF and nutritional status.
Birth Order ; Birth Weight ; Breast Feeding ; Child Development ; Child* ; Cross-Sectional Studies ; Diarrhea ; Diet ; Education ; Family Characteristics ; Fever ; Food, Fortified ; Growth and Development ; Growth Disorders ; Humans ; Incidence ; Indonesia* ; Infant ; Infant Nutritional Physiological Phenomena* ; Meals ; Methods ; Nutritional Status* ; Prevalence ; Thinness ; Vaccination ; Vitamin A

Since 2002, the number of marriages, births, and family members among multi-cultural families (MCFs) has increased. Beginning in 2006, the government initiated a planned management for such families and has implemented the MCF policy basic plan since 2010. In 2015, with multiple socio-economic and medical support initiatives for MCF being available, we analyzed the statistics for several factors related to birth, to determine whether there are significant adverse birth outcomes in MCF. We analyzed the birth data of MCFs in 2015, from Statistics Korea. This study compared the birth data of MCF and Korean families (KF) by geography, neonatal birth weight (BW), gestational age (GA), birth order of the neonates, place of delivery, cohabitation period of parents before the first child, and parental education level. The distribution of BW and the prevalence of low BW (< 2,500 g) or very low BW (< 1,500 g) were similar between both groups. The incidence of preterm birth was lower in the MCF group (6.5% vs. 7.0%, P = 0.015) than in the KF group. In the MCF group, parental education level was lower, and incidence of out-of-hospital births was higher than that of the KF group. Adverse birth outcomes, such as preterm birth and low BW in MCF are similar or better than KF. This study could be a good basis to present the status of MCF birth and newborn care in 2015.
Birth Order ; Birth Weight ; Child ; Education ; Geography ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Korea* ; Marriage ; Parents ; Parturition* ; Premature Birth ; Prevalence

PURPOSE: To compare the incidence of twin births with the length of first birth interval (LFBI: from marriage to first birth) among primiparous women. METHODS: The birth certificated data of Korea Statistics from 2010 to 2015 were used for this analysis. There were 1,356,204 births of primiparous women from total birth cases (2,736,296 births). The data involving multiparous women, teenage birth, extra-marital birth, and triplet birth cases were excluded from all analyses. Odds ratio and 95 percent confidence intervals were calculated from logistic regression to examine the risk of twin birth by LFBI adjusted for year of birth, maternal age, paternal age, age difference between couples, and maternal education and occupation. RESULTS: The frequency of LFBI was 41.5 percent in ≤12 months, 30.7 percent in 13~24 months, 13.1 percent in 25~36 months, and 2.1 percent in LFBI of ≥85 months. The mean LFBI was 21.5 months. The incidence of twin birth increased with prolonged LFBI. The twin birth rates per LFBI were 0.8 percent, 3.1 percent, 7.9 percent, and 11.0 percent in LFBI of ≤12 months, 25~36 months, 49~60 months, and 73~84 months, respectively. Odds ratio of twin births rate by LFBI were 1.510 (95% confidence interval: 1.449~1.574) for the LFBI of 13~24 months, 9.839 (9.390~10.309) for 49~60 months, and 13.244 (12.458~14.080) for ≥73~84 months, each compared with LFBI of ≤12 months. Odds ratio of twin birth rate in LFBI of ≤72 months was higher in women aged 35 and older, as compared to women aged ≤34 years. Odds ratio of twin birth rate by maternal age (≤34 years versus ≥35 years) reversed in LFBI of ≥73 months. CONCLUSION: The risk of twin birth increased significantly with prolonged LFBI. There is a need to understand the factors (fertility therapy and etc.) to increased risk of twin birth in prolonged LFBI.
Birth Intervals* ; Birth Order* ; Birth Rate ; Education ; Family Characteristics ; Female ; Humans ; Incidence* ; Korea* ; Logistic Models ; Marriage ; Maternal Age ; Occupations ; Odds Ratio ; Parturition* ; Paternal Age ; Triplets ; Twins*

PURPOSE: To compare the secular trends of gestational length distribution in singleton and twin birth by analyzing the birth certificated data of Statistics Korea. METHODS: The birth certificated data of Statistics Korea was used for this analysis (1997~99: 1,850,236 births, 2011~13: 1,325,301 births). The data of triplet birth cases, extra-marital birth, non-hospital birth cases, teenage birth, and gestational length information missing cases were excluded. Odds ratio and 95% confidence intervals were calculated from multinomial logistic regression analyses to describe the secular trend (1997~99 and 2011~13) of early preterm birth rate (≤33 weeks), late preterm birth rate (34~36 weeks), term birth rate (37~41 weeks), and post-term birth rate (≥42 weeks) adjusted for maternal age (20, 25, 30, 35, 40), birth order (1st=1, 2nd=2, ≧3rd=3), infantile gender (male=1, female=0), maternal occupation (none=1, yes=0), and education (≤middle=1, high=2, college/university=3). RESULTS: From phase I (1997~99) to phase II (2011~13), the gestational length distribution in singleton and twin births shifted the left and toward shorter gestational distribution, and mean gestational length decreased from 39.4 weeks to 38.7 weeks in singleton birth, and decreased from 36.9 weeks to 35.7 weeks in twin birth, During the period, the term birth rate of singleton birth was unchanged at 95 percent, but the term birth rate of twin birth was decreased from 65.7 percent to 46.1 percent. The odds ratio of early preterm birth, late preterm birth, term birth rate, and post-term birth rate in singleton birth for phase II were, respectively, 1.138 (95% confidence interval: 1.106~1.171), 1.556 (1.532~1.581), 1.094 (1.081~1.107), and 0.113 (0.109~0.118), compared with rate of each gestational length for phase I. The odds ratio of each gestational length in twin birth of phase II, comparing phase I, were 1.495 (1.405~1.590) for early preterm birth, 2.110 (2.029~2.194) for late preterm birth, 0.444 (0.428~0.461) for full term birth, and 0.055 (0.026-0.117) for post-term birth. CONCLUSION: The risk of early preterm birth, late preterm birth between phase I & II increased higher in twin birth than that of singleton birth. The rise in early and late preterm birth, and decrease in mean gestational length in singleton and twin birth during the period. There was a need to more research in this area to understand the contributing factors to gestational length.
Birth Order ; Birth Rate ; Education ; Humans ; Korea ; Logistic Models ; Maternal Age ; Occupations ; Odds Ratio ; Parturition* ; Premature Birth ; Term Birth ; Triplets ; Twins*

OBJECTIVES: We conducted a systematic review and meta-analysis to summarize current evidence regarding the association of parity and duration of breastfeeding with the risk of epithelial ovarian cancer (EOC). METHODS: A systematic search of relevant studies published by December 31, 2015 was performed in PubMed and EMBASE. A random-effect model was used to obtain the summary relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: Thirty-two studies had parity categories of 1, 2, and ≥3. The summary RRs for EOC were 0.72 (95% CI, 0.65 to 0.79), 0.57 (95% CI, 0.49 to 0.65), and 0.46 (95% CI, 0.41 to 0.52), respectively. Small to moderate heterogeneity was observed for one birth (p<0.01; Q=59.46; I²=47.9%). Fifteen studies had breastfeeding categories of <6 months, 6-12 months, and >13 months. The summary RRs were 0.79 (95% CI, 0.72 to 0.87), 0.72 (95% CI, 0.64 to 0.81), and 0.67 (95% CI, 0.56 to 0.79), respectively. Only small heterogeneity was observed for <6 months of breastfeeding (p=0.17; Q=18.79, I²=25.5%). Compared to nulliparous women with no history of breastfeeding, the joint effects of two births and <6 months of breastfeeding resulted in a 0.5-fold reduced risk for EOC. CONCLUSIONS: The first birth and breastfeeding for <6 months were associated with significant reductions in EOC risk.
Birth Order ; Breast Feeding* ; Female ; Humans ; Joints ; Ovarian Neoplasms* ; Parity* ; Parturition ; Population Characteristics ; Reproduction ; Risk Factors

PURPOSE: The aim of this study was to understand distress and posttraumatic growth (PTG) in mothers of children with cancer. METHODS: The data were collected through self-reported questionnaires completed by 222 mothers of children with cancer who had visited the hospital between 9th August and 17th September 2013. RESULTS: The results showed high distress both currently and at diagnosis in the majority of respondents. Analysis of the effects of general characteristics on PTG revealed that religious respondents, or those with considerable religious influence, had higher PTG. PTG was also higher in participants with 2 or more children, and for whom the patient was the second-born or later. There were no significant differences in PTG according to either the mother's characteristics (age, level of education, employment status, and burden of medical care costs) or the patient's characteristics (age, gender, birth order, diagnosis, duration of disease, and recurrence). CONCLUSION: The results of this study allowed a balanced observation of both positive and negative psychological states, such as distress and PTG, in mothers of children with cancer. These study findings may be useful foundation data for development of interventions to promote PTG.
Birth Order ; Child* ; Surveys and Questionnaires ; Diagnosis ; Education ; Employment ; Humans ; Mothers*