Maternal Smoking and Infant Low Birth Weight: Exploring the Biological Mechanism Through the Mother’s Pre-pregnancy Weight Status

Maternal smoking has been found to adversely affect birth outcomes, such as increasing the odds of having low birth weight infants. However, the mechanisms explaining how a mother’s smoking is linked to a child’s low birth weight status are underexplored. This study merged two nationally representative datasets in the United States (US)—the National Longitudinal Survey of Youth 1979 (NLSY79) and the NLSY79 Child and Young Adult (NLSYCYA)—to examine whether maternal weight status before pregnancy serves as a biological mechanism. We applied a recently developed mediation analysis technique to a data sample of 6550 mother–child pairs, and we compared the estimated coefficients across nested probability models. We found that maternal body mass index (BMI) (in kg/m²), a widely used measure of weight status, reduces the odds of delivering a low birth weight infant, and this mechanism explains about 10.2% of the adverse impact of maternal smoking on having a low birth weight child. Moreover, when categorizing maternal pre-pregnancy BMI into four weight statuses (i.e., underweight, normal weight, overweight, and obese), we found that, in contrast to mothers with normal weight status, underweight mothers are 70% more likely to have a low birth weight child. Our findings suggest that maternal weight status plays a role in understanding how maternal smoking affects low birth weight outcome, indicating that maintaining a proper weight status for women who plan to give birth may be a possible policy to promote infant health.

     

Family size and maternal health: evidence from the One-Child policy in China

In this paper, we examine the impact of family size on maternal health outcomes by exploiting the tremendous change in family size under the One-Child policy in China. Using data from the China Health and Nutrition Survey 1993–2006, we find that mothers with fewer children have a higher calorie intake and a lower probability of being underweight and having low blood pressure; meanwhile, they have a higher probability of being overweight. This would occur if a smaller family size increases the food consumption of mothers, leading underweight women to attain a normal weight and normal weight women becoming overweight. Robust tests are performed to provide evidence on the hypothesis that the tradeoff between children’s quantity and mother’s “quality” is through a budget constraint mechanism, that is, having more children decreases the resource allocated to mothers and affects their health outcomes.     

Another Gendered Demographic Dividend: Adjusting to a Future without Sons

Sonless families may pose a gendered demographic dividend. As fertility declines, families with only daughters are likely to grow. In turn, patriarchal family systems may weaken when many families are unable to engage in patriarchal practices. I examine some of these theorized dynamics in India. Sonless families did grow as fertility declined, reaching 10 percent in India as a whole in 2015 and approaching 20 percent in states with earlier fertility declines. I also identify a substantial influence of children's sex on mothers’ expectations of old-age support. Using panel data from the India Human Development Survey, I compare women's expectations after they had children to earlier expectations when they did not yet have children. Women with sons kept or further embraced patriarchal expectations that a son would provide support. Sonless mothers largely gave up patriarchal expectations, turning to daughters or away from children altogether.     

Family Structure and Children’s Economic Well-Being: Incorporating Same-Sex Cohabiting Mother Families

Research on family structure and child well-being rarely includes children in same-sex parent families, a notable omission since 28 % of female–female couple households contain children. Using the 2010–2013 pooled current population survey (CPS), we examined children’s economic well-being by family structure. These data were ideal for this study because they included a sizeable number of children in same-sex cohabiting mother families and the CPS measured both official and supplemental poverty, incorporating the cohabiting partner. Using the official poverty measure, children in same-sex cohabiting mother families were more likely to be poor than their counterparts in either different-sex cohabiting or married parent families. Using the supplemental poverty measure, children in same-sex mother families were no more likely to be poor than children in all other types of different-sex two-parent families.     

<Emphasis Type="Bold">Increasing Inequality in Parent Incomes and Children’s Schooling</Emphasis>

Income inequality and the achievement test score gap between high- and low-income children increased dramatically in the United States beginning in the 1970s. This article investigates the demographic (family income, mother’s education, family size, two-parent family structure, and age of mother at birth) underpinnings of the growing income-based gap in schooling using data from the Panel Study of Income Dynamics. Across 31 cohorts, we find that increases in the income gap between high- and low-income children account for approximately three-quarters of the increasing gap in completed schooling, one-half of the gap in college attendance, and one-fifth of the gap in college graduation. We find no consistent evidence of increases in the estimated associations between parental income and children’s completed schooling. Increasing gaps in the two-parent family structures of high- and low-income families accounted for relatively little of the schooling gap because our estimates of the (regression-adjusted) associations between family structure and schooling were surprisingly small for much of our accounting period. On the other hand, increasing gaps in mother’s age at the time of birth accounts for a substantial portion of the increasing schooling gap: mother’s age is consistently predictive of children’s completed schooling, and the maternal age gap for children born into low- and high-income families increased considerably over the period.     

Children in large families

A summary was provided of issues presented by Dr. Cynthia Lloyd in her chapter on investing in children from the 1994 volume "Population and Development: Old Debates, New Conclusions." Children in large families may miss the opportunities offered in a modernizing society. The possibilities for adverse consequences because of a large size of families include a smaller share of resources (time, income, and/or nutrition) among family members, limited access to public resources (health care and education), unequal distribution of resources among family members, and gender defined roles. Dr. Lloyd's review of the literature exposed the lack of emphasis on the impact of opportunity, equity, and intergenerational transfers on child welfare. Children's smaller share of resources had less impact on child welfare. Later-born and unwanted children were particularly vulnerable in large families. Unwanted children were usually later born or girls. The lack of investments in girl's education not only affected the limited earning power and opportunity to escape from gender restricting roles but also contributed to the perpetuation of the cycle of high fertility and gender discrimination. Family decisions about fertility and investments in children's education and nutrition can not be separated from the social context of culture, class, social custom, and level of socioeconomic development. Disadvantage is not assured in large families, but statistically more probable. Fewer children are more likely to be wanted and to receive better care. Societies should provide high quality family planning services, safe abortion services, and enforcement of primary school education requirements. Measures need to be adopted for promotion of schooling for girls that is sensitive to cultural norms. Laws must protect children's rights to economic support from both biological parents. Gender discrimination against women must be eliminated.     

多子一定多福吗：子女数量与母亲健康

本文基于CHARLS 2013年全国追踪调查数据分析了已婚子女对母亲健康的影响。为了克服子女数量所带来的内生性,本文基于计划生育政策在民族和城乡之间的差别进行因果识别。研究结果表明,对于子女都已成家的母亲来说,子女数量的增加会显著降低偏瘦和低血压的概率,提高高血压的概率,总体上不会显著提高身体健康的概率。但是对于60岁以上的老龄女性而言,子女数量的增加会显著降低偏瘦、低血压和肥胖的概率,提高高血压的概率,并且在总体上会显著提高身体健康的概率。     

Familial Effect on Child Poverty in Hong Kong Immigrant Families

This study investigated how family context affect poverty disparities between young children of immigrants from the Mainland China and children of local families whose parents were born in Hong Kong using 2006 bicensus data. 12,609 and 12,753 children of immigrant and local families were included in our data analyses. We find higher child poverty rates in immigrant families than in local families. Moreover, we found that family structure (single-parent vs. 2-parent), assimilation (first vs. second generation children of immigrant families), and parental human capital characteristics are significantly associated with the child poverty risk. Surprisingly, the impact of immigrant status on child poverty rates is stronger in 2-parent households than in single-parent households while child poverty declines associated with increasing assimilation defined by generational status of children are greater in 2-parent immigrant families than the corresponding declines in single-parent immigrant families. The implications of our results in intergenerational poverty are discussed.     

Family planning's benefits include improved child health and nutrition: new data from Bangladesh

2 recent studies from the Matlab in Bangladesh confirm that family planning promotes child survival. The 1st study is a longitudinal analysis of 3370 births in 1985 to women living in 70 villages who were served by the International Centre for Diarrhoeal Disease Research, Bangladesh's Matlab Family Planning and Health Services Project. The 2nd is a study of 12-26 month old children and 24-36 month old children, all of whom were born in the same 70 villages between July 1985 and June 1986. The 1st study demonstrates that family planning improves child survival by lengthening the birth interval. In fact, if women delay a subsequent birth by about 2 years, child survival improves at all ages up to 5 years. Longer birth intervals result in a reduction of very high order births. The same study also reveals that family planning improves child survival indirectly by granting mothers access to integrated maternal and child health services. The 2nd study indicates that a child is 3 times more likely to suffer malnutrition, even at age 3, than a child whose mother gives birth again at an interval greater than 24 months. Specifically, the mother removes the index child from the breast prematurely, thereby adversely affecting the index child's nutrition. The birth interval prior to the index child does not adversely affect the index child's nutritional status, however. The 2nd study's result suggest that birth spacing, as promoted by family planning programs, improves child health and nutrition. The findings from these studies show the importance of continued investments in family planning programs in developing countries.     

中国独生子女家庭与二孩家庭生育模式百年模拟与选择

不少人对中国的独生子女政策可能造成家庭负担过重忧心忡忡。通过独生子女家庭和“二孩加间隔”家庭未来百年发展变化模拟评价后认为：如果生育模式选择得当,独生子女家庭“四、二、二” 负担结构有可能基本避免,未来独生子女家庭的负担,也不会比历史上经历过的较重的负担更重。生育模式选择不当,生二个孩子,并不能保证比生一个孩子负担轻。从百年人口对资源环境和杜会经济发展的压力看,“二孩加间隔” 的政策无论如何组合和选择,所形成的人口压力都要显著大于独生子女政策,而独生子女家庭的生育模式如果选择得当,它的家庭负担不见得比生育模式选择不当的二孩家庭重多少。因此,政府应坚持稳定现行生育政策,坚持提倡一对夫妇只生一个孩子;同时应按最优生育模式,对生育年龄和间隔进行适当的调整。     

Child and Family Outcomes in New York and Tel AVIV: Using Social Indicators in a City Level Comparative Analysis

This article presents a comparative study in which social indicators were employed as a means to examine differences in living conditions and family and children outcomes on a local level. The study obtained household-level data on the well-being of children and families in two cities: New York (NYC) and Tel Aviv (TLV). Data were collected using computer assisted telephone interview (CATI) technology and random digit dialing (RDD). Telephone interviews were conducted with the randomly selected adults in English, Spanish and Chinese in NYC and in Hebrew in TLV. The study reported here documented differences in family and child well-being between the two cities. It further documented that family size and caregiver level of education play a similar role in both cities and their importance in regard to child and family outcomes. The significant differences found in adults’ and especially children’s outcomes were analyzed by the caregiver’s level of education and further support the need for policies that alleviate the burden of less educated caregivers and aim to improve the well-being of them and their families. The study demonstrates the relevance of social indicators at the local level, not only for measuring outcomes among specific populations, but also in regard to their possible implications for social policies, a most timely task in an era of social services devolution.     

Skewed Sex Ratios in India: “Physician, Heal Thyself”

Sex selection, a gender discrimination of the worst kind, is highly prevalent across all strata of Indian society. Physicians have a crucial role in this practice and implementation of the Indian Government’s Pre-Natal Diagnostic Techniques Act in 1996 to prevent the misuse of ultrasound techniques for the purpose of prenatal sex determination. Little is known about family preferences, let alone preferences among families of physicians. We investigated the sex ratios in 946 nuclear families with 1,624 children, for which either one or both parents were physicians. The overall child sex ratio was more skewed than the national average of 914. The conditional sex ratios decreased with increasing number of previous female births, and a previous birth of a daughter in the family was associated with a 38 % reduced likelihood of a subsequent female birth. The heavily skewed sex ratios in the families of physicians are indicative of a deeply rooted social malady that could pose a critical challenge in correcting the sex ratios in India.     

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.     

Early-life mortality clustering in families: A literature review

Research on early-life mortality in contemporary and historical populations has shown that infant and child mortality tend to cluster in a limited number of high-mortality families, a phenomenon known as ‘mortality clustering’. This paper is the first to review the literature on the role of the family in early-life mortality. Contemporary results, methodological and theoretical shortfalls, recent developments, and opportunities for future research are all discussed in this review. Four methodological approaches are distinguished: those based on sibling deaths, mother heterogeneity, thresholds, and excess deaths in populations. It has become clear from research to date that the death of an older child harms the survival chances of younger children in that family, and that fertility behaviour, earlier stillbirths, remarriages, and socio-economic status all explain mortality clustering to some extent.     

Between Abnormal “Otherness” to Groundbreaking “Uniqueness”: The Family-Construction Process of the GLBT Family

ABSTRACT

The GLBT family is a new postmodern phenomenon demonstrating the accomplishments of marginal groups seeking acceptance within mainstream society. The article is based on a qualitative phenomenological study conducted in Israel during 2012, providing a theoretical model combining a vast number of GLBT parenting options ranging from surrogacy, sperm donation, adoption, and co-parenting. The research consisted of 50 personal interviews that concentrated on the family experiences of couples of gay men and lesbian woman who opted to bring a child into their families. Analysis of the data points to a process of empowerment where societal norms in respect to gender, parenting, and family are deconstructed and then reconstructed. The theoretical model conceptualizes three parenting challenges that highlight the respondent’s family experience: “Otherness,” belonging, and self-actualization. Research shows that every period of family life addresses a different segment, where one of the three challenges becomes the dominant experience.     

Rural–Urban Child Height for Age Trajectories and Their Heterogeneous Determinants in Four Developing Countries

The large literature on health differentials between rural and urban areas relies almost exclusively on cross-sectional data. Bringing together the demographic literature on area-level health inequalities with the bio-physiological literature on children’s catch-up growth over time, this paper uses panel data to investigate the stability and origins of rural–urban health differentials. Using data from the Young Lives longitudinal study of child poverty, I present evidence of large level differences but similar trends in rural versus urban children’s height for age in four developing countries. Further, observable characteristics of children’s environment such as their household wealth, mother’s education, and epidemiological environment explain these differentials in most contexts. In Peru, where they do not, children’s birthweight and mothers’ health and other characteristics suggest that initial endowments—even before birth—may play an important role in explaining "residual" rural–urban child height inequalities. These latter results imply that prioritizing maternal nutrition and health is essential—particularly where rural–urban height inequalities are large. Interventions to reduce area-level health inequalities should begin even before birth.     

Prenatal development in rural South Africa: relationship between birth weight and access to fathers and grandparents

Birth weight is an indicator of prenatal development associated with health in infancy and childhood, and may be affected by the family environment experienced by the mother during pregnancy. Using data from KwaZulu-Natal, South Africa, we explore the importance of the mother's access to the father and grandparents of the child during pregnancy. Controlling for household socio-economic indicators and maternal characteristics, the survival and residence of the biological father with the mother are positively associated with birth weight. The type of relationship seems to matter: married women have the heaviest newborns, but co-residence with a non-marital partner is also associated with higher birth weight. Access to the maternal grandmother may also be important: women whose mothers are alive have heavier newborns, but no additional benefit is observed from residing together. Co-residence with any grandparent is not associated with birth weight after controlling for the mother's partnership.     

Mother’s home time and the production of child quality

This paper deals with the effect of mother’s time spent out of the labor force, and presumably in the home, on the “production” of child quality, where child quality is measured by intelligence (IQ), level of schooling attained, and market earning power. The results indicate that mother’s home time is most effective in producing (male) child quality for mothers who have attained relatively high levels of schooling. The results suggest that education programs which devote equal school resources to all (male) children do not necessarily provide equal educational opportunity and that the influence of family background on economic success is indirect, operating through home investments in children.     

Who is mommy tonight? Lesbian parenting issues

Developing an identity as mother and establishing what it means to mother is a task not defined by sexual orientation. Both heterosexual and homosexual women encounter role models and the dictates of society when mothering (Nelson, 1996). The present study explores how 18 lesbian adoptive parents, 49 lesbian parents who formed their families biologically, and 44 heterosexual adoptive parents experience and perceive their parenting role, how they respond when their children seek them or their partner for particular nurturing, and how the parents negotiate the cultural expectation of a primary caregiver. Lesbian couples were more equal in their division of childcare than heterosexual parents, and lesbian adoptive parents were the most egalitarian. In all types of dual parent families, parents were sought by their child for different activities. In heterosexual adoptive and lesbian biological families, the child's parental preference was rarely a source of conflict between partners. Lesbian adoptive parents were more likely to report that this preference caused occasional conflict. Reasons for this conflict are discussed in light of societal expectations of women and the role of mother.     

Midwives’ comprehension of care for women with intellectual disability during pregnancy and childbirth: An open-ended questionnaire study in Sweden

BackgroundFew studies have investigated midwifery care for women with intellectual disability (ID).AimTo gain a deeper understanding of midwives’ comprehension of care for women with ID during pregnancy and childbirth.MethodsA cross-sectional study among 375 midwives at antenatal clinics and delivery wards in Sweden. Findings 2476 quotations were sorted into six categories: information; communication and approach; the role of the midwife; preparing for and performing interventions and examinations; methods and assessments; and organisation of care. The midwives affirmed that individual, clear and repeated information together with practical and emotional support was important for women with ID. The midwives planned the care as to strengthen the capacity of the women, open doors for the unborn child and reinforce the process of becoming a mother. Extra time could be needed. They tried to minimise interventions. The midwives felt a dual responsibility, to support the mother–child contact but also to assess and identify any deficits in the caring capacity of the mother and to involve other professionals if needed.ConclusionsThe midwives described specially adapted organisation of care, models of information, practical education and emotional support to facilitate the transition to motherhood for women with ID. They have a dual role and responsibility in supporting the woman, while making sure the child is properly cared for. Healthcare services should offer a safe and trusted environment to enable such midwifery care. When foster care is planned, the society should inform and co-operate with midwives in the care of these women.