RESUMEN

Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children's behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.

Asunto(s)

Relaciones Madre-Hijo , Responsabilidad Parental , Humanos , Responsabilidad Parental/psicología , Lactante , Visita Domiciliaria , Preescolar , Conducta Materna/psicología

RESUMEN

BACKGROUNDS: Sleep restriction is considered a stressful condition itself, causing a wide variety of physiological alterations, from cognitive and hormonal to immunological status. In addition, it is established that stress in mother rats can modify milk ejection, milk composition, and maternal care of the pups. Also, sleep disturbances during the early stages of motherhood are a common feature of all studied species. In this context, while the impacts of sleep disruption in non-lactating animals were extensively investigated, its repercussions during the initial phases of motherhood have been poorly explored. Therefore, we wonder if maternal behavior, milk ejection and its macronutrient composition would be disrupted when mother rats are subjected to an additional acute or chronic sleep restriction to the already existing sleep disturbances. METHODS: Lactating rats were implanted with unilateral electrodes for polysomnographic recordings and for deep brain electrical stimulation into mesopontine waking-promoting area (for sleep deprivation). During the early postpartum period (postpartum day 5-9), mother rats were randomly assigned into one of three groups: chronic sleep restriction group (CSR; 6 h of sleep deprivation/day for five consecutive days), acute sleep restriction group (ASR; 6 h of sleep deprivation only for one day), or undisturbed group (control group). Active maternal behaviors (retrievals of the pups into the nest, mouthing, lickings [corporal and anogenital] and sniffing the pups) and passive maternal behaviors (kyphotic and supine nursing postures) were evaluated during a 30 min period without sleep restriction immediately after the sleep restriction or control period. The litter weight gain was assessed every day, and on the last experimental session mothers were milked for posterior macronutrients analysis (protein, carbohydrates and fat). RESULTS: When compared to control group, CSR decreased the amount of milk ejected in the middle days of the sleep restriction period, while ASR did not affect this parameter. Moreover, ASR reduced milk protein content compared to control and CSR groups. Finally, compared to the control group, CSR reduced active maternal behaviors towards the end of the treatment days. CONCLUSIONS: We demonstrated that not only acute but also chronic sleep restriction impacts on the postpartum period, each one affecting different aspects of maternal behavior and lactation. Our results suggest the existence of a homeostatic recovery mechanism in breastfeeding during CSR, possibly ensuring the survival of the litter, while the decline in active maternal behaviors appears to be cumulative.

Asunto(s)

Lactancia , Privación de Sueño , Femenino , Humanos , Ratas , Animales , Lactancia/fisiología , Sueño/fisiología , Periodo Posparto , Conducta Materna/fisiología , Nutrientes

RESUMEN

INTRODUCTION: The quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile. MATERIALS AND METHOD: Eighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions. RESULTS: Exclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants. CONCLUSION: Breastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.

Asunto(s)

Lactancia Materna , Salud Mental , Relaciones Madre-Hijo , Humanos , Lactancia Materna/psicología , Femenino , Relaciones Madre-Hijo/psicología , Adulto , Lactante , Embarazo , Madres/psicología , Adulto Joven , Periodo Posparto/psicología , Masculino , Chile , Conducta Materna/psicología , Recién Nacido

RESUMEN

Maternal stress is consistently linked to alterations in maternal behavior and infant neurodevelopmental outcomes. As the Latino population grows in the U.S., it is increasingly important to understand how culturally relevant factors affect this relationship. This study aimed to address the role of sociocultural stressors on maternal sensitivity and markers of infant emotional regulation and the neuroendocrine response to stress in mother/infant dyads of Mexican descent. Pregnant women of Mexican descent (n = 115) were recruited during early pregnancy and followed until their infants were 6 months old. Mothers completed measures of sociocultural stressors (acculturative stress and discrimination) at pre and postnatal time points. At 6 months, dyads underwent the Still Face procedure. Mothers were observed for behaviors exhibiting maternal responsivity, while negative vocalizations were observed in infants. Salivary cortisol was also collected from infants. Maternal responsivity was a salient risk factor for alterations in infant emotional regulation and cortisol activity. Postnatal experiences of discrimination were also negatively associated with infant negative affect. This work highlights maternal responsivity and points to a potential role for experiences of discrimination in the response to stress in the mother/child dyad that may have consequences for the development of emotional regulation in infants of Mexican descent.

Asunto(s)

Hidrocortisona , Estrés Psicológico , Lactante , Niño , Humanos , Femenino , Embarazo , Estrés Psicológico/psicología , Madres/psicología , Conducta Materna , Sistemas Neurosecretores , Relaciones Madre-Hijo/psicología

RESUMEN

Este estudo se dedica a pensar os efeitos do racismo e da racialidade enquanto elementos estruturantes do mundo em que vivemos e da saúde sexual e reprodutiva de mulheres negras, seus projetos de vida e exercício de parentalidade. Por meio de uma perspectiva sobre a impossibilidade da justiça, considerando a necessidade de destruição do Mundo como o conhecemos, e iluminando (com luz negra) a perversidade que não é uma falha mas é a característica mesma do projeto racial que está na base das formações sociais modernas, este trabalho dá centralidade à potência dos emaranhados sociais e da coletividade na produção de estratégias de continuidade da vida, dialogando com as noções de rede e sobrevivência coletiva. Seu objetivo é entender os sentidos e práticas das redes de apoio de mulheres racializadas durante o ciclo gravídico puerperal e no exercício de cuidado à prole em contexto de vulnerabilização. Este é um estudo qualitativo de caráter analítico- exploratório cujas fontes de dados foram produções da literatura científica, registros em diário de campo e discursos das mulheres participantes. Os instrumentos da pesquisa foram uma roda de conversa e duas entrevistas individuais de mulheres mães pretas e periféricas; e a análise elaborada a partir da metodologia episódica proposta por Grada Kilomba. Esta autora encontrou nas narrativas de histórias pessoais de mulheres negras, episódios de suas vidas, a possibilidade de reconstruir e recuperar percepções e definições próprias dos sujeitos que as experenciaram e as têm como própria realidade. Os resultados construídos revelam que os sentidos e práticas das redes de apoio das mulheres-mães negras periféricas envolvidas nesse estudo são múltiplos e ambíguos. Ao mesmo tempo em que possibilitam a emancipação da mulher ao papel da mãe que se dedica integralmente aos filhos em detrimento de seus desejos individuais descolados da maternagem, são também moduladores de sua maternagem e reprodutores da opressão imposta por esse modelo socialmente consolidado. O cenário é complexo, há disputas de gênero, poder institucionalizado, mecanismo de manutenção da visão do outro racial como identidade e referência, jogos de poder e conflito geracional, interesses próprios, alianças consanguíneas, relações por aliança, abandono, vida, vitórias, acolhimento, esperança, acordos, negociações, uma miríade de elementos que sustentam a existência destes sujeitos. Suas maternagens são especialmente atravessadas por eventos críticos, mortes materiais e simbólicas, que tornam seu sofrimento cotidiano e determinam que ressignifiquem sua existência diariamente, à medida em que compartilham o cuidado de seus filhos com seus pares.

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This study is dedicated to thinking about the effects of racism and raciality as structuring elements of the world we live in as well as of black women's sexual and reproductive health, their life projects and parenting. Through a perspective on the impossibility of justice, considering the need to destroy the world as we know it, and by shedding (black) light on the perversity that is not a failure but the very characteristic of the racial project that underpins modern social formations, this work focuses on the power of social entanglements and collectivity in the production of strategies for the continuity of life, engaging with the notions of networks and collective survival. It aims to understand the meanings and practices of racialized women's support networks during the pregnancy-puerperium cycle and when caring for their offspring in a context of vulnerability. This is a qualitative study of an analytical-exploratory type and its data sources were scientific literature, field diary entries and the speeches of the participating women. The research instruments were a conversation circle and two individual interviews with black women who are mothers from a peripheral region, and the analysis was based on the episodic methodology proposed by Grada Kilomba. This author found in the narratives of black women's personal stories, episodes from their lives, the possibility of reconstructing and retrieving the perceptions and definitions of the subjects who experienced them and have them as their own reality. The results show that the meanings and practices of support networks of the black women who are mothers in the periphery and were involved in this study are multiple and ambiguous. At the same time as they make it possible for women to emancipate themselves from the role of mothers who dedicate themselves entirely to their children, in detriment to their individual desires detached from mothering, they are also modulators of their mothering and reproducers of the oppression imposed by this socially consolidated model. The scenario is complex, there are gender disputes, institutionalized power, a mechanism for maintaining the view of the racial other as an identity and reference, power games and generational conflict, self-interest, consanguineous alliances, alliance relations, abandonment, life, victories, acceptance, hope, agreements, negotiations, a myriad of elements that sustain the existence of these subjects. Their mothering is especially crossed by critical events, material and symbolic deaths, which make their suffering a daily occurrence and determine that they resignify their existence on a regular basis, as they share the care of their children with their peers.

Asunto(s)

Humanos , Femenino , Apoyo Social , Grupos Raciales , Salud Reproductiva , Conducta Materna , Relaciones Madre-Hijo , Población Negra

RESUMEN

Esta pesquisa investigou narrativas maternas sobre a hospitalização de seus bebês cronicamente adoecidos em uma maternidade pública do município de São Paulo, no ano de 2022, a partir da análise temática de quatro entrevistas semiestruturadas. O material coletado foi discutido em articulação com as contribuições da psicanálise, organizado em três eixos centrais. As mães entrevistadas parecem ter encontrado caminhos possíveis para o exercício da função materna e constituição do laço com seus bebês. Suas experiências foram marcadas por sentimentos ambivalentes e relatos de sofrimento psíquico que demandam cuidados em saúde mental. Buscou-se criar aproximações com a realidade estudada, lançando um olhar para experiências originais de maternagem e para aimportância da construção de dispositivos de cuidado atentos às necessidades das figuras parentais e de seus bebês em contexto de hospitalização e adoecimento

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Se investigó narrativas maternas sobre la hospitalización de sus bebés crónicamente enfermos, en una maternidad pública de la ciudad de São Paulo, en el año 2022, desde el análisis temático de cuatro entrevistas semiestructuradas. El material recopilado fue discutido en articulación con los aportes del psicoanálisis, organizado en tres ejes centrales. Las madres entrevistadas parecen haber encontrado posibles formas de ejercer la función materna y construir un vínculo con su bebé. Sus vivencias estuvieron marcadas por sentimientos ambivalentes y relatos de sufrimiento psíquico que demandan atención en salud mental. Se intentó crear aproximaciones con la realidad estudiada, mirando experiencias originales de la maternidad y la importancia de construir dispositivos de cuidado atentos a las necesidades de las figuras parentales y sus bebés en el contexto de hospitalización y enfermedad

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This study investigated mothers' narratives about their chronically ill babies' hospitalization at a public maternity hospital in São Paulo, during 2022, based on thematic analysis of four semi-structured interviews. The main qualitative data from interviews were analyzed concerning its psychoanalytic contribution, organized by three central themes. Interviewed mothers seemed to have found possible ways to perform the maternal function and bond with their babies. Their experiences were affected by ambivalent feelings and psychic suffering that demands mental health care. The aim was to come closer to this reality, remarking original motherhood experiences and the importance of developing caregiving practices worried about the needs of parental figures and their babies in the context of hospitalization and illness

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Cette recherche étudie les récits maternels sur l'hospitalisation de leurs bébés souffrant de maladie chronique, dans une maternité publique de la ville de São Paulo, en 2022, à partir de l'analyse thématique de quatre entretiens semi-structurés. Le matériel collecté a été discuté en articulation avec les apports de la psychanalyse, organisés en trois axes centraux. Les mères interrogées semblent avoir trouvé des moyens possibles d'exercer la fonction maternelle et de créer un lien avec leur bébé. Leurs expériences ont été marquées par des sentiments ambivalents et des rapports de souffrance psychique qui exigent des soins de santé mentale. Nous avons cherché à créer des rapprochements avec la réalité étudiée, en s'intéressant aux expériences originales de la maternité et à l'importance de construire des dispositifs de soins attentifs aux besoins des figures parentales et de leurs bébés dans le cadre de l'hospitalisation et de la maladie

Asunto(s)

Humanos , Masculino , Femenino , Recién Nacido , Lactante , Adolescente , Adulto , Niño Hospitalizado , Enfermedad Crónica , Distrés Psicológico , Lactante , Conducta Materna/psicología , Relaciones Madre-Hijo , Unidades de Cuidado Intensivo Neonatal , Salud Mental , Afecto , Narración

RESUMEN

O presente estudo é um recorte de uma pesquisa mais ampla sobre a experiência da maternidade de mulheres brasileiras migrantes. Ele tem como objetivo investigar o apoio recebido por elas no processo de tornar-se mãe. Trata-se de uma pesquisa qualitativa na qual foram realizadas, em 2022, sete entrevistas com mulheres brasileiras que vivenciaram gestação, parto e primeiro ano de vida do filho (a) em Portugal, Reino Unido, Itália, Espanha e França. Os resultados apontam para a relevância da presença de pessoas que compartilham da mesma cultura de origem na construção da maternidade e na rede de apoio durante a perinatalidade. Conclui-se que o distanciamento da rede familiar, de amigos e de referenciais da cultura de origem da mulher migrante gerou o aumento das sobrecargas psíquica e física inerentes à maternidade. Ao mesmo tempo, de acordo com as participantes, o distanciamento da família e da cultura de origem proporcionou maior liberdade e abertura para a construção da maternidade, provendo novas representações culturais que contribuíram para a construção de sua forma de ser mãe.(AU)

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This study is a segment of a broader research project on the maternity experience of Brazilian migrant women. It aims to investigate the support received by these women in the process of becoming mothers. It encompasses a qualitative research study involving seven interviews conducted in 2022 with Brazilian women who experienced pregnancy, childbirth, and the first year of their child's life in Portugal, the United Kingdom, Italy, Spain, and France. The findings highlight the importance of having individuals sharing the same cultural background in the construction of motherhood and in the support network during the perinatal period. The distance from the family network, friends, and references of the migrant woman's culture of origin generated an increase in the psychic and physical burdens inherent to motherhood. Simultaneously, according to the participants, distancing from family and their cultural origins provided greater freedom and openness in constructing motherhood, offering new cultural representations that contributed to shaping their way of being mothers. (AU)

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El presente estudio es parte de una investigación más amplia acerca de la experiencia de la maternidad de las mujeres migrantes brasileñas. Tiene como objetivo investigar el soporte recibido por ellas en el proceso de convertirse en madre. Se trata de una investigación cualitativa en la que, en 2022, se realizaron siete entrevistas con mujeres brasileñas que vivieron el embarazo, el parto y el primer año de vida de su hijo en Portugal, Reino Unido, Italia, España y Francia. Los resultados apuntan para la relevancia de la presencia de personas que comparten la misma cultura de origen en la construcción de la maternidad y en la red de apoyo durante la perinatalidad. Se concluye que el alejamiento de la red familiar, amigos y puntos de referencia de su cultura de origen de la mujer migrante ha generado un aumento de las sobrecargas psíquicas y físicas inherentes a la maternidad. Al mismo tiempo, según las participantes, el alejamiento de la familia y de la cultura de origen les ha proporcionado una mayor libertad y apertura para la construcción de la maternidad, brindando nuevas representaciones culturales que contribuyeron para la construcción de su forma de ser madre. (AU)

Asunto(s)

Humanos , Femenino , Embarazo , Adulto , Embarazo/psicología , Conducta Materna , Atención Prenatal , Apoyo Social , Atención Perinatal , Factores Culturales , Investigación Cualitativa , Migración Humana , COVID-19

RESUMEN

Introdução:Os pais exercem um importante papel no estabelecimento dos hábitos saudáveis durante a infância.Aoprestarem cuidados bucais necessários às suas crianças, observa-se um significativo resultado na prevenção dos agravos.Objetivo:Identificaroconhecimento materno sobre os cuidados bucais das crianças na primeira infância. Metodologia:Trata-se de um estudo de natureza quantitativa do tipo exploratório e observacional. A coleta ocorreu através da aplicação de um questionário semiestruturado, com questões sobre o conhecimento materno em relação à higiene bucal, hábitos alimentares, acometimento de cárie e perfil socioeconômico. Realizou-se uma análise descritiva dos dados, seguida de análise bivariada pelo teste do Qui-quadrado de Pearson, considerando-se um nível de significância de 5%. Resultados:Sobre o conhecimento dos cuidados bucais dos filhos, o mesmo encontrou-se insatisfatório em relação à idade em que as crianças devem começar a escovar seus dentes sozinhas,quanto ao uso de escova e docreme dental fluoretado como método de higiene após a erupção do primeiro dente e quanto à inexistência do dente decíduo antes do nascimento dos molares permanentes. Observou-se conhecimento satisfatório em relação à importância de se realizar restauraçãoem dente decíduo acometido por cárie,à idade em que a criança troca os dentes decíduos pelos permanentes e, à realização de algum cuidado bucal (fralda e gaze) antes do nascimento do primeiro dente.Conclusões:Há uma lacuna quanto às orientações de saúde bucal providas pelos dentistasdirecionadas às mães. As mães/gestantes têm o conhecimento adequado sobre os cuidados bucais do bebê, porém, quanto aos cuidados após o nascimento do primeiro dente, os resultados foram desfavoráveis. Faz-se necessário a maior participação do cirurgião-dentista nas consultas de pré-natal e de crescimento e desenvolvimento praticando educaçãoem saúde (AU).

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Introduction:Parents play an important role in establishing healthy habits during childhood. Providing necessary oral care to their children significantly contributes to preventing oral health issues.Objective: To verify maternal knowledge about children's oral care in early childhood.Methodology:Thisis a quantitative, exploratoryandobservationalstudy. Data werecollectedthroughtheapplicationof a semistructuredquestionnaire, withquestionsabout maternal knowledgeregarding oral hygiene, eatinghabits, caries involvementandsocioeconomic profile. A descriptivedata analysiswasperformed, followedby a bivariate analysis, usingPearson's chi-square test, considering a 5% significance level. Results:Regardingmothers' knowledge about their children's oral care, it was unsatisfactory in relation to the age at which children should start brushing their teeth by themselves; regarding the use of a toothbrush and fluoride toothpaste as hygiene methods, after the first tooth's eruption, and regarding the absence of the deciduous tooth before the permanent molars eruption. Satisfactory knowledge was observed regarding the importance of carrying out restoration in decayed deciduous teeth; the age at which children begin to change deciduous teeth for permanent ones and, carrying out some oral care (fabric and gauze) before the first tooth's eruption. Conclusions:There is a gap in the oral health guidelines provided by dentists, aimed to mothers. The mothers/pregnant women have sufficient knowledge about their baby's oral care, but considering the oral care after the first tooth eruption, the results were critical. It is necessary a greater participation of the dentist in prenatal and growth and development consultations, practicing Health Education (AU).

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Introducción: Los padres ejercen un papel importante en el establecimiento de hábitos saludables durante la infancia. Al proporcionar el cuidado bucal necesario a sus hijos, se obtienen resultados importantes en la prevención de enfermedades. Objetivo: Identificar el conocimiento materno sobre el cuidado bucal de los niños en la primera infancia. Metodología:Se trata de un estudio cuantitativo de carácter exploratorio yobservacional. La colecta ocurrió mediante la aplicación de un cuestionario semiestructurado, con preguntas sobre conocimientos maternos sobre higiene bucal, hábitos alimentarios, caries y perfil socioeconómico. Se realizó un análisis descriptivo de los datos, seguido de un análisis bivariado mediante la prueba Chi-cuadrado de Pearson, considerando un nivel de significancia del 5%. Resultados:En cuanto al conocimiento sobre el cuidado bucal de los niños, se encontró insatisfactorio en relación a la edad en la que los niños deben comenzar a cepillarse los dientes solos, en cuanto al uso de cepillos dentales y pasta dental fluorada como método de higiene después de la erupción del primer diente y la ausencia de un diente temporal antes del nacimiento de los molares permanentes. Se observó conocimiento satisfactorio sobre la importancia de restaurar un diente temporal afectado por caries, la edad en que el niño cambia los dientes temporales por permanentes y la provisión de algunos cuidados bucales (pañal y gasa) antes del nacimiento del primer diente. Conclusiones:Existe un vacío en la orientación sobre salud bucal proporcionada por los odontólogos dirigida a las madres. Las madres/gestantes tienen conocimientos adecuados sobre el cuidado bucal de su bebé, sin embargo, en relación a los cuidados después del nacimiento del primer diente los resultados fueron desfavorables. Es necesaria una mayor participación del odontólogo en las consultas prenatales y de crecimiento y desarrollo, practicando la educación para la salud (AU).

Asunto(s)

Humanos , Masculino , Femenino , Embarazo , Niño , Higiene Bucal/educación , Cuidado del Niño/psicología , Salud Bucal/educación , Conducta Materna/psicología , Distribución de Chi-Cuadrado , Encuestas y Cuestionarios , Razón de Prevalencias

RESUMEN

Objetivo: discutir as percepções das mães que são profissionais de saúde sobre as relações na unidade neonatal. Método: estudo qualitativo, apoiado no Interacionismo Simbólico, com 11 mães de recém-nascidos pré-termo que são profissionais da saúde. Após aprovação pelo Comitê de Ética em Pesquisa, os dados foram coletados de maio a outubro de 2021, por meio de entrevistas individuais, e submetidos à análise de conteúdo temática. Resultados: apesar de as mães serem profissionais da saúde, as relações na unidade neonatal foram difíceis, sofridas, desconfortantes e restritivas ao processo de 'ser e tornar-se mãe'. Estas desvelaram sentimentos de não pertencimento ao cuidado e de afastamento de suas crianças. Conclusão: as relações entre mães e profissionais da saúde atuantes na unidade neonatal estiveram marcadas por sofrimentos, limitações e desconfortos, sendo lacunares em processos colaborativos, na contramão do Cuidado Centrado na Família(AU)

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Objective: to discuss the perceptions of mothers who are health professionals about relationships in the neonatal unit. Method: a qualitative study, based on Symbolic Interactionism, with 11 mothers of preterm newborns who are health professionals. After approval by the Research Ethics Committee, data was collected from May yo October 2021, through individual interviews, and subjected to thematic content analysis. Results: despite the mothers being health professionals, relationships in the neonatal unit were difficult, painful, uncomfortable, and restrictive to the process of 'being and becoming a mother'. They revealed feelings of not belonging to care and of being away from their children. Conclusion: the relationships between mothers and health professionals working in the neonatal unit were marked by suffering, limitations, and discomfort, and were lacking in collaborative process, going against Family-Centered Care(AU)

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Objetivo: discutir las percepciones de las madres profesionales de salud sobre las relaciones en la unidad neonatal. Método: estudio cualitativo, basado en el Interaccionismo Simbólico, con 11 madres de recién nacidos prematuros que son profesionales de la salud. Previa aprobación del Comité de Ética en Investigación, se recolectaron los datos de mayo a octubre de 2021, mediante entrevistas individuales y los sometieron a análisis temático de contenido. Resultados: aunque las madres eran profesionales de salud, las relaciones en la unidad neonatal fueron difíciles, dolorosas, incómodas y restrictivas al proceso de 'ser y volverse madre'. Revelaron sentimientos de no pertenencia a los cuidados y de alejamiento de sus hijos. Conclusión: las relaciones entre las madres y los profesionales sanitarios que trabajan en la unidad neonatal estaban marcadas por el sufrimiento, las limitaciones y la incomodidad, y carecían de procesos de colaboración, lo que iba en contra de la Atención Centrada en la Familia(AU)

Asunto(s)

Humanos , Femenino , Embarazo , Recién Nacido , Adulto , Persona de Mediana Edad , Relaciones Profesional-Familia , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Periodo Posparto , Madres/psicología , Investigación Cualitativa , Conducta Materna

RESUMEN

INTRODUCTION: This study investigates the effects of repetitive pinprick stimulation on preterm offspring and its impact on nociceptive responses and inflammatory hypersensitivity in adulthood. OBJECTIVES: The objective is to shed light on the potential long-term consequences of neonatal pain and prematurity on sensory processing. METHODS: Term and preterm rats were subjected to repetitive pinprick (PP) stimulation or control (CC) during the neonatal period. Adult rats received CFA injection to induce inflammatory hypersensitivity, and mechanical hypersensitivity was measured. Gender differences in inflammatory hypersensitivity were also examined. Maternal behavior, litter weight, and offspring growth were monitored to assess any potential influences of the stimulation on these parameters. RESULTS: In preterm rats, the PP stimulation did not affect baseline thresholds to mechanical stimuli, but increased mechanical hypersensitivity after CFA injection in adult rats. Females exhibited greater inflammatory hypersensitivity compared to males. Maternal behavior, litter weight, and offspring growth were not influenced by the stimulation. PP stimulation during the neonatal period led to changes in nociceptive responses in adulthood, potentially altering sensory processing. CONCLUSION: PP stimulation in preterm rats during the neonatal period resulted in changes in nociceptive responses in adulthood, leading to increased inflammatory hypersensitivity. The study emphasizes how early development can significantly impact sensory processing and further highlights the potential long-term consequences of prematurity and neonatal pain on this processing.

Asunto(s)

Conducta Materna , Nocicepción , Femenino , Masculino , Humanos , Animales , Ratas , Dolor , Sensación , Caracteres Sexuales

RESUMEN

Punishing, minimizing, ignoring, or becoming distressed when dealing with children's negative emotions may favor the emergence or worsen behavior problems during childhood. This study examined the effects of the intervention program Vivendo Emoções [Experiencing Emotions] on maternal reactions to children's emotions and children's internalizing and externalizing problems. Thirty-two mothers of children aged between three and eight participated and were assigned to an intervention (n = 16) or a comparison (n = 16) group. The intervention was implemented in eight sessions intended to promote the mothers' strategies to identify and regulate their children's negative emotions and enable the children to improve emotional competence. The mothers completed the CCNES to report their reactions to children's emotional expressions and the CBCL to report internalizing and externalizing problems on pretest and posttest. The results reveal that mothers in the intervention group reported fewer unsupportive reactions on posttest than mothers in the comparison group. This finding shows the potential of such interventions to decrease unsupportive maternal reactions. Additionally, children in the intervention group presented more frequent somatic complaints than those in the comparison group on posttest. A potential explanation is that the mothers were more prepared to encourage their children to report negative emotions associated with bodily sensations.

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Castigar, minimizar, ignorar o manifestar malestar ante la expresión de emociones negativas de los niños puede favorecer la aparición o el empeoramiento de problemas de comportamiento en la infancia. Este estudio examinó los efectos del programa de intervención Viviendo Emociones, focado en la socialización emocional de los niños, en las reacciones maternas a las emociones y en los problemas internalizantes y externalizantes de los niños. Participaron 32 madres de niños entre tres y ocho años, divididas en los grupos intervención (n = 16) y comparación (n = 16). El Viviendo Emociones se realizó en ocho sesiones y busca promover estrategias para identificar y regular las emociones negativas expresadas por los niños para que ellos amplíen su competencia emocional. En el pre-test y post-test, las madres respondieron el CCNES para reportar sus reacciones ante las expresiones emocionales de sus hijos y el CBCL para reportar problemas internalizantes y externalizantes. Los resultados revelaron que las madres en el grupo de intervención reportaron menos reacciones de no apoyo que las madres en el grupo comparación en el post-test. Ese hallazgo resalta el potencial de intervenciones de esta naturaleza para reducir las reacciones maternas de no apoyo. Adicionalmente, los niños del grupo intervención presentaron más quejas somáticas que los niños del grupo comparación en el post-test. Una explicación potencial es que las madres estaban más preparadas para alentar a los niños a reportar emociones negativas asociadas a sensaciones corporales.

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Punir, minimizar, ignorar ou manifestar desconforto diante da expressão de emoções negativas dos filhos pode favorecer o surgimento ou agravamento dos problemas de comportamento na infância. Este estudo examinou os efeitos do programa de intervenção, Vivendo Emoções, com foco na socialização emocional infantil, sobre as reações maternas às emoções dos filhos e os problemas internalizantes e externalizantes das crianças. Participaram 32 mães de crianças entre três e oito anos, divididas em grupo intervenção (n = 16) e comparação (n = 16). O Vivendo Emoções foi realizado em oito sessões e busca promover estratégias para identificação e regulação das emoções negativas expressas pelos filhos de forma que a criança amplie sua competência emocional. No pré-teste e no pós-teste, as mães responderam a CCNES para informar suas reações às expressões emocionais nos filhos e o CBCL para relatar problemas internalizantes e externalizantes. Os resultados revelaram que as mães do grupo intervenção relataram menos reações não apoiadoras do que as mães do grupo comparação no pós-teste. Esse achado evidencia o potencial de intervenções dessa natureza para reduzir reações maternas não apoiadoras. Adicionalmente, as crianças do grupo intervenção apresentaram mais queixas somáticas do que as crianças do grupo comparação no pós-teste. Uma explicação potencial é que as mães estivessem mais preparadas para encorajar as crianças a relatar emoções negativas associadas a sensações corporais.

Asunto(s)

Humanos , Masculino , Femenino , Preescolar , Niño , Socialización , Conducta Infantil/psicología , Emociones/fisiología , Problema de Conducta/psicología , Madres/psicología , Relaciones Padres-Hijo , Psicoterapia/métodos , Lista de Verificación , Factores Sociodemográficos , Conducta Materna/fisiología

RESUMEN

This chapter presents a brief overview of attachment theory and discusses the importance of the neonatal period in shaping an individual's physiological and behavioural responses to stress later in life, with a focus on the role of the parent-infant relationship, particularly in rodents. In rodents, the role of maternal behaviours goes far beyond nutrition, thermoregulation and excretion, acting as hidden regulators of the pup's physiology and development. In this review, we will discuss the inhibitory role of specific maternal behaviours on the ACTH and corticosterone (CORT) stress response. The interest of our group to explore the long-term consequences of maternal deprivation for 24 h (DEP) at different ages (3 days and 11 days) in rats was sparked by its opposite effects on ACTH and CORT levels. In early adulthood, DEP3 animals (males and females alike) show greater negative impact on affective behaviours and stress related parameters than DEP11, indicating that the latter is more resilient in tests of anxiety-like behaviour. These findings create an opportunity to explore the neurobiological underpinnings of vulnerability and resilience to stress-related disorders. The chapter also provides a brief historical overview and highlights the relevance of attachment theory, and how DEP helps to understand the effects of childhood parental loss as a risk factor for depression, schizophrenia, and PTSD in both childhood and adulthood. Furthermore, we present the concept of environmental enrichment (EE), its effects on stress responses and related behavioural changes and its benefits for rats previously subjected to DEP, along with the clinical implications of DEP and EE.

Asunto(s)

Encéfalo , Conducta Materna , Masculino , Humanos , Femenino , Ratas , Animales , Ansiedad , Corticosterona , Privación Materna , Hormona Adrenocorticotrópica , Estrés Psicológico/psicología

RESUMEN

OBJECTIVE: Supportive paternal caregiving is influenced by contextual factors, including maternal caregiving behaviors. Although longer periods of breastfeeding have been found to be associated with higher levels of maternal supportive parenting, it remains unknown whether the benefits of breastfeeding also extend to fathers' supportive caregiving. This study tested the indirect relation between the duration of breastfeeding and paternal supportive parenting through maternal supportive parenting. METHODS: Participating families (N = 623) were from the Behavior Outlook Norwegian Developmental Study, a population-based longitudinal study in Southeast Norway. Path analysis was used to test associations between the duration of breastfeeding in the first year (parent report) and paternal supportive parenting (observed, 36 months), as potentially mediated by maternal supportive parenting (observed, 24 months). RESULTS: After controlling for sociodemographic and birth factors, a longer duration of breastfeeding was indirectly associated with higher levels of observed paternal supportive parenting through maternal supportive parenting. CONCLUSION: The current findings suggest that the longer breastfeeding duration during the first year of life (i.e., infancy) might have important implications for both maternal and paternal supportive parenting in toddlerhood.

Asunto(s)

Lactancia Materna , Padre , Masculino , Femenino , Humanos , Preescolar , Estudios Longitudinales , Conducta Materna , Responsabilidad Parental , Madres

RESUMEN

We explored a possible role of oxytocin (OXT) for the onset and maintenance of rabbit maternal behavior by: (a) confirming that a selective oxytocin receptor antagonist (OTA) widely used in rodents selectively binds to OXT receptors (OXTR) in the rabbit brain and (b) determining the effect of daily intracerebroventricular (icv) injections of OTA to primiparous and multiparous does from gestation day 29 to lactation day 3. OTA efficiently displaced the high affinity, selective oxytocin receptor (OXTR) radioligand, 125 I-labeled ornithine vasotocin analog (125 I-OVTA), but was much less effective at displacing the selective V1a vasopressin receptor radioligand, 125 I-labeled linear vasopressin, thus showing high affinity and selectivity of OTA for rabbit OXTR as in rodents. Further, ICV OTA injections did not modify nest-building, latency to enter the nest box, time spent nursing or the amount of milk produced, relative to vehicle-injected does. The percentage of mothers suckling the litter was also similar between both groups, regardless of parity. Together, our results do not support a role of OXT for the initiation or maintenance of rabbit maternal behavior. Future studies are warranted to determine if OXT participates in fine-tuning additional aspects of the maternal ethogram, for example, circadian periodicity of nursing and nest defense.

Asunto(s)

Oxitocina , Receptores de Oxitocina , Embarazo , Animales , Femenino , Conejos , Humanos , Receptores de Oxitocina/metabolismo , Oxitocina/farmacología , Oxitocina/metabolismo , Encéfalo/metabolismo , Lactancia , Conducta Materna

RESUMEN

The evolutionary roots of care for injured, ill, and disabled group members remain unclear. The same can be said about care for dying and dead group members. Accumulating case reports in a variety of nonhuman primates can shed light on these origins. Here we provide a detailed account of interactions of a wild capuchin monkey mother and other group members with a disabled infant before and after its death. Limb disability caused the infant to be in unstable positions when carried, which appeared to increase the frequency of body readjustments by the adults and may have contributed to its death. After death, no adults other than the mother made contact with the corpse, but four immatures approached and touched it. The mother foraged only on flies surrounding the corpse while carrying it, stopped several times to set the corpse down on the branches, and let it finally fall as she leapt between trees. The difficulty of carrying disabled and dead individuals up in the trees may help to explain the scarcity of reports in platyrrhines, and suggests that terrestriality and increasing ease of bipedality may have contributed to the evolution of these behaviors in primates.

Asunto(s)

Muerte , Madres , Femenino , Animales , Humanos , Conducta Materna , Cadáver , Cebus

RESUMEN

Objetivo: compreender as percepções maternas acerca do diagnóstico de Síndrome de Down (SD) de seus filhos quando crianças. Método: estudo exploratório-descritivo com abordagem qualitativa realizado com 9 mães de crianças com SD em um hospital público de nível terciário no município de São Paulo. A coleta dos dados ocorreu por meio de entrevistas individuais e semiestruturadas, guiadas por roteiro de tópicos. Os dados foram analisados por meio da análise temática de conteúdo e à luz dos princípios de ancoragem e objetivação da Teoria das Representações Sociais. Resultados: Os dados foram analisados e emergiram duas categorias principais: 1) as percepções maternas em relação à comunicação do diagnóstico de SD do filho; e 2) as percepções maternas acerca do impacto do diagnóstico de SD do filho, com subcategorias interligadas. Conclusão: constatou-se manejo predominantemente inadequado dos profissionais ao comunicarem o diagnóstico de SD, o que potencializou as reações emocionais de sofrimento, que não se restringiram ao momento da notícia. As reações podem ser amenizadas ou potencializadas com a vivência da maternagem e com interações familiares, sociais e com profissionais de saúde.(AU)

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Objective: to understand maternal perceptions about the diagnosis of Down Syndrome (DS) of their children as children. Method: Exploratory-descriptive study with a qualitative approach carried out with 9 mothers of children with DS in a tertiary public hospital in the city of São Paulo. Data collection took place through individual and semi-structured interviews, guided by a script of topics. Data were analyzed using thematic content analysis and considering the principles of anchoring and objectification of the Theory of Social Representations. Results: data were analyzed, and two main categories emerged: 1) maternal perceptions regarding communication of the child's DS diagnosis; and 2) maternal perceptions about the impact of the child's DS diagnosis, with interconnected subcategories. Conclusion: There was predominantly inadequate management by professionals when communicating the diagnosis of DS, which potentiated the emotional reactions of suffering, which were not restricted to the moment of the news. Reactions can be mitigated or enhanced with the experience of motherhood and with family and social interactions and with health professionals.(AU)

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Objetivo: comprender las percepciones maternas sobre el diagnóstico del niño con Síndrome de Down (SD). Método: estudio exploratorio-descriptivo con enfoque cualitativo, realizado con madres de niños con SD, en un hospital público de tercer nivel, en el municipio de São Paulo. La recolección se realizó a través de entrevistas individuales y semiestructuradas, regidas por un guión de temas. Los datos fueron analizados mediante análisis temático de contenido y a la luz de los principios de anclaje y objetivación de la Teoría de las Representaciones Sociales. Resultados: participaron 9 madres de niños con SD. Los datos se analizaron y surgieron dos categorías principales: 1) Percepciones maternas sobre la comunicación del diagnóstico de SD del hijo, y 2) Percepciones maternas sobre el impacto del diagnóstico de SD del hijo, con subcategorías interconectadas. Conclusión: se constató manejo predominantemente inadecuado de los profesionales en la comunicación del diagnóstico de SD, lo que potenció las reacciones emocionales de sufrimiento, que no se restringieron al momento de la noticia. Las reacciones se pueden mitigar o mejorar con la experiencia de la maternidad, las interacciones con los miembros de la familia, los profesionales de la salud y sociales.(AU)

Asunto(s)

Humanos , Femenino , Adolescente , Adulto , Síndrome de Down/diagnóstico , Relaciones Madre-Hijo , Síndrome de Down/enfermería , Entrevista , Investigación Cualitativa , Conducta Materna/psicología

RESUMEN

Animal models are crucial to understanding the mechanisms underlying the deleterious consequences of early-life stress. Here, we aimed to examine the effect of the limited bedding nesting (LBN) paradigm on early life development milestones and anxiety- and/or depression-like behavior in adolescent and adult mice from two inbred mice of both sexes. C57BL/6NCrl and BALB/c litters were exposed to the LBN paradigm postnatal day (PND) 2-9. Maternal behavior recording occurred on PND 3-9, and pups were weighed daily and examined to verify the eye-opening on PND 10-22. The male and female offspring underwent evaluation in the open field test, elevated plus-maze, and the forced swimming test during adolescence (PND 45-49) and adulthood (PND 75-79). We found that LBN impaired the maternal behavior patterns of both strain dams, mainly on C57BL/6NCrl strain. Also, LBN delayed the pup's eye-opening time and reduced body weight gain, impacting C57BL/6NCrl pups more. We also found that LBN decreased anxiety-related indices in adolescent and adult male but not female mice of both strains. Furthermore, LBN decreased depression-related indices only adolescent female and male BALB/c and female but not male C57BL/6NCrl mice. These findings reinforce the evidence that the LBN paradigm impairs the maternal behavior pattern and pup's early developmental milestones but does not induce anxiety- or depressive-like behavior outcomes during later life.

Asunto(s)

Trastornos de Ansiedad , Ansiedad , Masculino , Humanos , Femenino , Animales , Ratones , Ratones Endogámicos C57BL , Conducta Materna , Ropa de Cama y Ropa Blanca , Conducta Animal

RESUMEN

Objective We compared parental educational practices and emotional health of 62 mothers of students from nuclear (G1) and non-nuclear families (G2). Method We used an inventory of parenting practices and scales for assessment of anxiety, stress and depression. Results G1 showed significantly higher means for Moral Behavior. Positive correlations between negative parenting educational practices and clinical indicators for maternal emotional health were perceived in both groups and more significantly for G2. Younger mothers in G1 indicated more signs of state anxiety and for G2 the lower socioeconomic level indicated more signs of stress and trait anxiety and less depression. Conclusion The data can contribute to the planning of interventions.

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Objetivo Comparar e relacionar práticas educativas parentais e saúde emocional de 62 mães de escolares de famílias nucleares (G1) e não nucleares (G2). Método Utilizou-se um inventário de práticas parentais e escalas para avaliação da ansiedade, estresse e depressão. Resultados O G1 apresentou significativamente médias superiores para Comportamento Moral. Correlações positivas entre as práticas educativas parentais negativas e indicadores clínicos para saúde emocional materna foram percebidos em ambos os grupos e de forma mais expressiva para G2. Mães mais jovens em G1 indicaram mais sinais de ansiedade-estado. Já para G2, o nível socioeconômico inferior indicou mais sinais de estresse e ansiedade-traço e menos depressão. Conclusão Os dados podem contribuir para o planejamento de intervenções.

Asunto(s)

Familia , Salud Mental , Conducta Materna

RESUMEN

A pandemia de covid-19 provocou intensas mudanças no contexto do cuidado neonatal, exigindo dos profissionais de saúde a reformulação de práticas e o desenvolvimento de novas estratégias para a manutenção da atenção integral e humanizada ao recém-nascido. O objetivo deste artigo é relatar a atuação da Psicologia nas Unidades Neonatais de um hospital público de Fortaleza (CE), Brasil, durante o período de distanciamento físico da pandemia de covid-19. Trata-se de estudo descritivo, do tipo relato de experiência, que ocorreu no período de março a agosto de 2020. No contexto pandêmico, o serviço de Psicologia desenvolveu novas condutas assistenciais para atender às demandas emergentes do momento, como: atendimento remoto; registro e envio on-line de imagens do recém-nascido a seus familiares; visitas virtuais; e reprodução de mensagens de áudio da família para o neonato. Apesar dos desafios encontrados, as ações contribuíram para a manutenção do cuidado centrado no recém-nascido e sua família, o que demonstra a potencialidade do fazer psicológico.(AU)

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The COVID-19 pandemic brought intense changes to neonatal care and required health professionals to reformulate practices and develop new strategies to ensure comprehensive and humanized care for newborn. This study aims to report the experience of the Psychology Service in the Neonatal Units of a public hospital in Fortaleza, in the state of Ceará, Brazil, during the social distancing period of the COVID-19 pandemic. This descriptive experience report study was conducted from March to August 2020. During the pandemic, the Psychology Service developed new care practices to meet the emerging demands of that moment, such as remote care, recordings and online submission of newborns' pictures and video images for their family, virtual tours, and reproduction of family audio messages for the newborns. Despite the challenges, the actions contributed to the maintenance of a care that is centered on the newborns and their families, which shows the potential of psychological practices.(AU)

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La pandemia de la COVID-19 ha traído cambios intensos en el contexto de la atención neonatal, que requieren de los profesionales de la salud una reformulación de sus prácticas y el desarrollo de nuevas estrategias para asegurar una atención integral y humanizada al recién nacido. El objetivo de este artículo es reportar la experiencia del Servicio de Psicología en las Unidades Neonatales de un hospital público de Fortaleza, en Ceará, Brasil, durante el periodo de distanciamiento físico en la pandemia de la COVID-19. Se trata de un estudio descriptivo, un reporte de experiencia, que se llevó a cabo de marzo a agosto de 2020. En el contexto pandémico, el servicio de Psicología desarrolló nuevas conductas asistenciales para atender a las demandas emergentes del momento, tales como: atención remota; grabación y envío em línea de imágenes del recién nacido; visitas virtuales; y reproducción de mensajes de audio de la familia para el recién nacido. A pesar de los desafíos encontrados, las acciones contribuyeron al mantenimiento de la atención centrada en el recién nacido y su familia, lo que demuestra el potencial de la práctica psicológica.(AU)

Asunto(s)

Humanos , Femenino , Embarazo , Recién Nacido , Lactante , Psicología , Teletrabajo , COVID-19 , Neonatología , Ansiedad , Terapia por Inhalación de Oxígeno , Puntaje de Apgar , Grupo de Atención al Paciente , Alta del Paciente , Pediatría , Perinatología , Fototerapia , Atención Prenatal , Calidad de la Atención de Salud , Respiración Artificial , Instituciones de Cuidados Especializados de Enfermería , Sobrevida , Anomalías Congénitas , Inconsciente en Psicología , Visitas a Pacientes , Servicio de Ginecología y Obstetricia en Hospital , Niveles de Atención de Salud , Brasil , Lactancia Materna , Informes de Casos , Recién Nacido , Recien Nacido Prematuro , Cardiotocografía , Conductas Relacionadas con la Salud , Unidades de Cuidado Intensivo Pediátrico , Unidades de Cuidado Intensivo Neonatal , Desarrollo Infantil , Servicios de Salud del Niño , Mortalidad Infantil , Mortalidad Materna , Infección Hospitalaria , Riesgo , Probabilidad , Estadísticas Vitales , Indicadores de Salud , Esperanza de Vida , Salud de la Mujer , Tamizaje Neonatal , Enfermería , Nutrición Enteral , Cuidados a Largo Plazo , Nutrición Parenteral , Embarazo de Alto Riesgo , Docilidad , Atención Integral de Salud , Tecnología de Bajo Costo , Índice de Embarazo , Vida , Creatividad , Cuidados Críticos , Afecto , Llanto , Parto Humanizado , Incertidumbre , Mujeres Embarazadas , Presión de las Vías Aéreas Positiva Contínua , Prevención de Enfermedades , Humanización de la Atención , Acogimiento , Tecnología de la Información , Nutrición del Niño , Mortalidad Perinatal , Resiliencia Psicológica , Miedo , Métodos de Alimentación , Monitoreo Fetal , Pase de Guardia , Microbiota , Integralidad en Salud , Atención Ambulatoria , Trastornos del Neurodesarrollo , Salud Materna , Sepsis Neonatal , Medicina de Urgencia Pediátrica , Sistemas de Apoyo Psicosocial , Supervivencia , Pruebas de Estado Mental y Demencia , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias , Apoyo Familiar , Ginecología , Hospitalización , Maternidades , Hiperbilirrubinemia , Hipotermia , Sistema Inmunológico , Incubadoras , Enfermedades del Recién Nacido , Tiempo de Internación , Acontecimientos que Cambian la Vida , Amor , Conducta Materna , Bienestar Materno , Medicina , Métodos , Enfermedades del Sistema Nervioso , Apego a Objetos , Obstetricia

RESUMEN

Abstract Objectives: the first five years of life are critical for children's physical and intellectual development. However, the under-five mortality rate in South Asia and ASEAN is relatively high, caused by complex etiologies. This paper identifies maternal high-risk fertility behaviors and healthcare services utilization and examines predictors of under-five mortality (U5M) in 7 Asian (South Asia - ASEAN) developing countries (Indonesia, Myanmar, Cambodia, Philippines, Bangladesh, Nepal, and Pakistan). Methods: a multivariate logistic regression model with a complex survey was used to examine predictors of U5M on the frequency of U5M adjusted for comorbidities. Results: according to multivariate models (model 2), U5M was 2.99 times higher in mothers with low weight at birth infants than in mothers without low weight at birth infants (aOR= 2.99; CI95%=2.49-3.58); Mothers without antenatal care contacts were 3.37 times more likely (aOR= 3.37; CI95%=2.83-4.00) to have a U5M than mothers with eight or more antenatal care contacts; U5M in Indonesia was 2.34 times higher (aOR= 2.34; CI95%= 1.89-2.89). It is investigated that antenatal care serves as a predictor in decreasing U5MR. Conclusions: in order to achieve significant U5MR reduction, intervention programs that encourage antenatal care consultations should be implemented.

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Resumo Objetivos: os primeiros cinco anos de vida são críticos para o desenvolvimento físico e intelectual da criança. No entanto, a taxa de mortalidade de menores de cinco anos no sul da Ásia e na ASEAN é relativamente alta, causada por etiologias complexas. Este artigo identifica comportamentos maternos de fertilidade de alto risco e utilização de serviços de saúde e examina preditores de mortalidade abaixo de 5 anos (MM5) em 7 países em desenvolvimento da Ásia (Sul da Ásia - ASEAN) (Indonésia, Mianmar, Camboja, Filipinas, Bangladesh, Nepal e Paquistão). Métodos: um modelo de regressão logística multivariada foi usado para examinar preditores de MM5 na frequência de MM5 ajustado para comorbidades. Resultados: na análise multivariada (modelo 2), U5M foi 2,99 vezes maior em mães com bebês com baixo peso ao nascer do que em mães sem bebês com baixo peso ao nascer (aOR= 2,99; IC95%=2,49-3,58); as mães sem contatos de cuidados pré-natais tiveram 3,37 vezes mais probabilidade (aOR=3,37; IC95%=2,83-4,00) para ter MM5 do que mães com oito ou mais contatos de cuidados pré-natais; MM5 na Indonésia foi 2,34 vezes maior (aOR= 2,34; IC95%= 1,89-2,89). Investiga-se que os cuidados pré-natais funcionam como um preditor na diminuição da MM5. Conclusões: para uma redução significativa da MM5, devem ser implementados programas de intervenção que estimulem as consultas pré-natais.

Asunto(s)

Humanos , Recién Nacido , Lactante , Preescolar , Atención Prenatal , Mortalidad Infantil , Factores de Riesgo , Mortalidad , Mortalidad del Niño , Conducta Materna , Servicios de Salud Materno-Infantil , Sur de Asia