@misc{LoefflerGrosserMianietal., author = {L{\"o}ffler, Antje and Grosser, Angelique and Miani, Celine and Doyle, Ina-Merle and Razum, Oliver and Spallek, Jacob}, title = {Einflussfaktoren auf die Einf{\"u}hrung von Beikost bei S{\"a}uglingen - Ergebnisse der BaBi-Geburtskohorte in Deutschland}, series = {Gesundheitswesen 2019}, volume = {81}, journal = {Gesundheitswesen 2019}, number = {08/09}, publisher = {Georg Thieme Verlag KG}, address = {Stuttgart}, doi = {10.1055/s-0039-1694423}, pages = {686 -- 686}, abstract = {Hintergrund: Im ersten Lebensjahr erfolgt ein schrittweiser {\"U}bergang von Muttermilch bzw. S{\"a}uglingsmilchnahrung zur Familienkost, wobei die erste Gabe von Beikost zwischen 5. und 7. Lebensmonat erfolgen soll. Es ist wenig bekannt {\"u}ber soziodemographische bzw. klinische Einflussfaktoren auf die Beikosteinf{\"u}hrung. Methodik: Datengrundlage der vorliegenden Untersuchung waren Baseline und erstes Follow-Up der Bielefelder Geburtskohorte BaBi (2013 - 2016, n = 777). Angaben zur Stilldauer, Einf{\"u}hrung von Beikost sowie der Getr{\"a}nkegabe vor und w{\"a}hrend der Einf{\"u}hrung von Beikost wurden telefonisch erhoben, als die S{\"a}uglinge zwischen neun und 12 Monaten alt waren. Einflussfaktoren auf die Beikosteinf{\"u}hrung wurden mittels bi-und multivariater Datenanalyse untersucht. Ergebnisse: Bei Einf{\"u}hrung der Beikost waren die S{\"a}uglinge im Mittel 5,4 ± 1,2 Monate alt. 2,6\% der S{\"a}uglinge waren j{\"u}nger als vier Monate, 12,5\% der S{\"a}uglinge waren {\"a}lter als 6,5 Monate. Lineare Regressionsanalysen zeigten eine direkte Assoziation zwischen der ausschließlichen Stilldauer bzw. dem S{\"a}uglingsalter bei letzter Mutter-/S{\"a}uglingsmilchgabe und dem Beikostbeginn (b = 0,31 [95\%KI = 0,26 - 0,36; p ≤ 0,001; b = 0,12 [95\% KI 0,07 - 0,18], p ≤ 0,001). M{\"u}tterliche Determinanten wie Alter, Bildungsstatus, Migrationsstatus, Familienstand, Parit{\"a}t, pr{\"a}nataler BMI und Rauchstatus vor und w{\"a}hrend der Schwangerschaft hatten keinen Einfluss auf den Beginn der Beikostgabe. 73,6\% der befragten Frauen gaben an, schon einmal Probleme mit dem F{\"u}ttern seit Beginn der Beikosteinf{\"u}hrung gehabt zu haben. Diskussion: In der vorliegenden Analyse erfolgte der Beikostbeginn unabh{\"a}ngig von soziodemographischen und klinischen Parametern, jedoch f{\"u}hrte l{\"a}ngeres ausschließliches Stillen bzw. l{\"a}ngere Mutter-/S{\"a}uglingsmilchgabe zu einem sp{\"a}teren Beikostbeginn. Weitere Untersuchungen sind notwendig, um Art, Umfang und m{\"o}gliche Auswirkungen berichteter Probleme bei der Beikosteinf{\"u}hrung bzw. eines verz{\"o}gerten Beikostbeginns auf Mutter und Kind zu quantifizieren.}, language = {de} } @misc{MianiRazumSpallek, author = {Miani, C{\´e}line and Razum, Oliver and Spallek, Jacob}, title = {Health of the offspring of immigrants: the BaBi birth cohort study}, series = {Public Health Forum}, volume = {27}, journal = {Public Health Forum}, number = {4}, issn = {1876-4851}, doi = {10.1515/pubhef-2019-0062}, pages = {298 -- 300}, abstract = {Children with a migration background are more at risk of health-related problems than those without a migration background. The German health system still does not adequately meet the challenges of on increasingly heterogeneous population, not least due to a lack of adequate epidemiological data and models. The BaBi study contributes to gaining new insights in the development of health inequalities due to cultural diversity in Germany, with a focus on pregnancy and early childhood.}, language = {en} } @misc{MianiLudwigDoyleetal., author = {Miani, C{\´e}line and Ludwig, Angelique and Doyle, Ina-Merle and Breckenkamp, J{\"u}rgen and H{\"o}ller-Holtrichter, Chantal and Spallek, Jacob and Razum, Oliver}, title = {The role of education and migration background in explaining differences in folic acid supplementation intake in pregnancy: Results from a German birth cohort study}, series = {Public Health Nutrition}, journal = {Public Health Nutrition}, issn = {1475-2727}, doi = {10.1017/S1368980021003621}, pages = {1 -- 24}, abstract = {Objective: Official German recommendations advise women to start taking folic acid supplementation (FAS) before conception and continue during the first pregnancy trimester to lower the risk of birth defects. Women from lower socioeconomic background and ethnic minorities tend to be less likely to take FAS in other European countries. As little is known about the determinants of FAS in Germany, we aimed to investigate the association between FAS and formal education and migration background, adjusting for demographic factors. Design: We used data (2013-2016) on nutrition and socioeconomic and migration background from the baseline questionnaire of the BaBi cohort study. We performed multivariate regressions and mediation analyses. Setting: Bielefeld, Germany. Participants: 947 women (pregnant or who had given birth in the past two months). Results: 16.7\% of the participants (158/947) didn't use FAS. Migration-related variables (e.g. language, length of stay) were not associated with FAS in the adjusted models. FAS was lower in women with lower level of formal education and in unplanned pregnancies. Reasons given by women for not taking FAS were unplanned pregnancy and lack of knowledge of FAS. Conclusions: Health practitioners may be inclined to see migrant women as an inherently at-risk group for failed intake of FAS. However, it is primarily women who did not plan their pregnancy, and women of lower formal education level, who are at risk. Different public health strategies to counter low supplementation rates should be supported, those addressing the social determinants of health (i.e. education) and those more focussed on family planning.}, language = {en} } @misc{LudwigDoyleLoeffleretal., author = {Ludwig, Angelique and Doyle, Ina-Merle and L{\"o}ffler, Antje and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver and Miani, Celine}, title = {The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany}, series = {Midwifery}, volume = {86}, journal = {Midwifery}, issn = {1532-3099}, doi = {10.1016/j.midw.2020.102688}, abstract = {Breastfeeding is beneficial for both mother and child. A breastfed child can benefit from improved mental developments, protection against infectious diseases and infectious disease mortality, and a decreased risk of overweight and obesity (Whalen and Cramton 2010)(Regional Office for Europe (World Health Organisation) 2019). Furthermore, there is evidence on protection against type 1 and 2 diabetes, allergic rhinitis, asthma or wheezing, atopic dermatitis, childhood leukemia, hypercholesterolemia later in life, sudden infant death syndrome (Whalen and Cramton 2010) and malocclusion (Victora et al. 2016). Breastfeeding women have a lower risk of breast and ovarian cancer, postpartum depression, and type 2 diabetes. They can, furthermore, benefit from prolonged lactational amenorrhea (Victora et al. 2016), improved postpartum sleep (Whalen and Cramton 2010) and postpartum weight loss (Kramer and Kakuma 2012).}, language = {en} } @misc{WandschneiderBatramZantvoortAlazeetal., author = {Wandschneider, Lisa and Batram-Zantvoort, Stephanie and Alaze, Anita and Niehues, Vera and Spallek, Jacob and Razum, Oliver and Miani, C{\´e}line}, title = {Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study}, series = {Women's Health}, volume = {18}, journal = {Women's Health}, issn = {1617-8041}, doi = {10.1177/17455057221114274}, pages = {1 -- 17}, abstract = {Objectives: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave. Methods: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April-May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews' data to further understand the determinants of the women's mental well-being. Results: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood. Discussion: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it.}, language = {en} } @misc{MianiBatramZantvoortWandschneideretal., author = {Miani, C{\´e}line and Batram-Zantvoort, Stephanie and Wandschneider, Lisa and Spallek, Jacob and Razum, Oliver}, title = {Potential of Standard Perinatal Data for Measuring Violation of Birth Integrity}, series = {Frontiers in global women's health}, journal = {Frontiers in global women's health}, number = {1}, issn = {2673-5059}, doi = {10.3389/fgwh.2020.581244}, pages = {8}, abstract = {Background: Measuring the phenomenon of violation of birth integrity (vBI) (e.g., obstetric violence) relies in part on the availability and content of maternity care providers' data. The population coverage and linkage possibilities that these data provide make for a yet untapped potential. Although vBI is a complex phenomenon best measured with dedicated instruments, we argue that maternity care providers' data could contribute to enhance our knowledge of the manifestations and frequency of vBI, and allow for analyses across different sub-groups of the population. Looking into the German standardized perinatal data, we investigate which variables are relevant to vBI-related research, and how complete their reporting is. Methods: First, we analyse state-of-the-art frameworks and recommendations, and, for each vBI-related domain, we search for and list corresponding variables in the perinatal data which could contribute to a better understanding of vBI issues. Second, we use an example and analyse the content of perinatal data obtained between 2013 and 2016 in the context of the BaBi birth cohort study set in Bielefeld, Germany. We use descriptive statistics to assess the completeness of the data. Results: The vBI-related variables can be classified in three main categories: discrimination based on specific patient socio-demographic attributes (e.g., height and weight to calculate BMI before pregnancy, foreign origin), indication for medical interventions (i.e., medicalization-related variables: indication for cesarean sections and induction), and supportive care, in particular the mobilization dimension (e.g., continuous fetal heartbeat monitoring). The data analyses included 876 births, of which 601 were vaginal birth. We found poor reporting on demographic variables in terms of completeness. Medicalization and mobilization variables are better documented, although limited in scope. Conclusions: Putting more emphasis on the completeness of standardized data could increase their potential for vBI-related research. Perinatal data alone are insufficient to assess vBI, but a broader, theory-informed discussion of indicators to be included in standardized datasets would contribute to capturing the different aspects of integrity violation in a more systematic way and expand the evidence-base on different types of vBI.}, language = {en} } @misc{LudwigMianiBreckenkampetal., author = {Ludwig, Angelique and Miani, C{\´e}line and Breckenkamp, J{\"u}rgen and Sauzet, Odile and Borde, Theda and Doyle, Ina-Merle and Brenne, Silke and H{\"o}ller-Holtrichter, Chantal and David, Matthias and Spallek, Jacob and Razum, Oliver}, title = {Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies}, series = {Maternal and Child Health Journal}, volume = {24}, journal = {Maternal and Child Health Journal}, number = {7}, issn = {1573-6628}, doi = {10.1007/s10995-020-02937-z}, pages = {943 -- 952}, abstract = {Objective: Non-medical antenatal care (ANC) refers to a range of non-medical services available to women during pregnancy aiming at supporting women and prepare them for the birth and the postpartum period. In Germany, they include antenatal classes, breastfeeding classes and pregnancy-specific yoga or gymnastics courses. Studies suggest that various types of non-medical ANC carry benefits for both the women and their babies. Little is known about the uptake of non-medical ANC among different socioeconomic population subgroups, but one may expect lower utilization among socio-economically disadvantaged women. We analyzed factors contributing to the utilization of non-medical ANC in general and antenatal classes in particular. Methods: Baseline data of the Bielefeld BaBi birth cohort (2013-2016) and the Berlin perinatal study (2011-2012) were analyzed. Comparing the two cohorts allowed to increase the socio-economic and migration background variance of the study population and to capture the effect of the local context on uptake of services. Multivariate logistic regression analyses were performed to study associations between the uptake of non-medical ANC and socio-economic and migration status.ResultsIn Berlin and Bielefeld, being a first generation migrant and having lower levels of education were associated with lower non-medical ANC uptake. In Berlin, being a 2nd generation woman or having a low income was also associated with lower uptake. Conclusions for Practice: Our study suggests that non-medical ANC remains in some part the prerogative of non-migrant, well-educated and economically privileged women. Since differences in non-medical ANC have the potential to create inequalities in terms of birth outcomes and maternal health during pregnancy and post-partum, more efforts are needed to promote the use of non-medical ANC by all population groups.}, language = {en} } @misc{MianiLudwigBreckenkampetal., author = {Miani, Celine and Ludwig, A. and Breckenkamp, J{\"u}rgen and Sauzet, Odile and Doyle, Ina-Merle and H{\"o}ller-Holtrichter, Chantal and Spallek, Jacob and Razum, Oliver}, title = {Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study}, series = {BMC pregnancy and childbirth}, volume = {20}, journal = {BMC pregnancy and childbirth}, issn = {1471-2393}, doi = {10.1186/s12884-020-2725-5}, pages = {7}, abstract = {BACKGROUND: Women with a migration background are reportedly at a higher risk of emergency caesarean section. There is evidence that this is due in part to suboptimal antenatal care use and quality of care. Despite the fact that migrant women and descendants of migrants are often at risk of socioeconomic disadvantage, there is, in comparison, scarce and incomplete evidence on the role of socioeconomic position as an independent risk factor for emergency caesarean delivery. We therefore investigate whether and how migration background and two markers of socioeconomic position affect the risk of an emergency caesarean section and whether they interact with each other. METHODS: In 2013-2016, we recruited women during the perinatal period in Bielefeld, Germany, collecting data on health and socioeconomic and migration background, as well as routine perinatal data. We studied associations between migration background (1st generation migrant, 2nd/3rd generation woman, no migration background), socioeconomic status (educational attainment and net monthly household income), and the outcome emergency caesarean section. RESULTS: Of the 881 participants, 21\% (n = 185) had an emergency caesarean section. Analyses showed no association between having an emergency caesarean section and migration status or education. Women in the lowest (< 800€/month) and second lowest (between 800 and 1750€/month) income categories were more likely (aOR: 1.96, CI: 1.01-3.81; and aOR: 2.36, CI: 1.27-4.40, respectively) to undergo an emergency caesarean section than women in the higher income groups. CONCLUSIONS: Migration status and education did not explain heterogeneity in mode of birth. Having a low household income, however, increased the chances of emergency caesarean section and thereby contributed towards producing health disadvantages. Awareness of these findings and measures to correct these inequalities could help to improve the quality of obstetric care.}, language = {en} } @misc{GrosserDoyleLoeffleretal., author = {Grosser, Angelique and Doyle, Ina-Merle and L{\"o}ffler, Antje and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver and Miani, Celine}, title = {The impact of psychosocial factors on breastfeeding duration in the BaBi cohort study, Germany}, series = {European Journal of Public Health}, volume = {29}, journal = {European Journal of Public Health}, number = {4}, issn = {1464-360X}, doi = {10.1093/eurpub/ckz187.122}, pages = {2}, abstract = {Background: Breastfeeding is considered beneficial for both mother and child. In Germany, national guidelines recommend fully breastfeeding for at least 4 months, a goal reached by only 34\% of mothers in 2012. The WHO's recommendation of exclusively breastfeeding for six months was met by 19\% only. Hardly modifiable factors such as socio-economic status and migration background have been associated with duration of breastfeeding but little is known about the impact of psychosocial factors such as personality traits and social support. We hypothesise that there are differences in the psychosocial profiles of mothers regarding the duration of breastfeeding. Methods: We analyse baseline and follow-up data of the Bielefeld BaBi birth cohort (2013-16). They include detailed migration and socio-economic backgrounds, as well as three measures of psychological characteristics: the optimism scale, the Big Five inventory and the locus of control scales. We perform bivariate and multivariate analyses in order to identify psychosocial determinants of fully breastfeeding for four and six months. Results: Out of 780 BaBi study participants, 548 fully breastfed for four months (70.3\%), of which 279 continued until at least six months (35.8\%). Logistic regression analyses show that fully breastfeeding for at least four or six months is independently associated with the intention to breastfeed and the attendance of antenatal class during this or previous pregnancies. Personality characteristics, social status and migration background show however no significant association with breastfeeding duration. Conclusions: Our study results support the promotion of individuals' breastfeeding intention and attendance to antenatal classes to increase breastfeeding duration. Since differences in breastfeeding practices have the potential to create inequalities in maternal and child health, more efforts are needed to intensify research on modifiable factors influencing breastfeeding duration.}, language = {en} } @misc{GrosserHoellerHoltrichterMianietal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Miani, Celine and Hoffmann, Renata and Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob}, title = {Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany}, series = {European Journal of Public Health}, volume = {27}, journal = {European Journal of Public Health}, number = {Suppl. 3}, issn = {1464-360X}, doi = {10.1093/eurpub/ckx187.467}, pages = {S. 183}, language = {en} }