Respiratory symptoms at 2 months and 1 year
Hallit S., Leynaert B., Delmas M.-C., Rocchi S., De Blic J., Marguet C., Scherer E., Dufourg M.-N., Bois C., Reboux G., Millon L., Charles M.-A., Raherison C., “Wheezing phenotypes and risk factors in early life: The ELFE cohort”. PloS One. 2018 Apr 27.
Little is know about the prevalence of respiratory disease in early childhood, which is why the Elfe families were asked about their children’s wheezing and other respiratory symptoms at 2 months and again at 1 year.
Analysis showed that 77.2% of the infants remained symptom free (controls), 2.1% had wheezing at 2 months but not at 1 year (intermittent), 2.4% had wheezing at both 2 months and 1 year (persistent), and 18.3% had wheezing at 1 year (incident).
Analysis of environmental factors showed that maternal smoking during pregnancy was associated with both incident and persistent wheezing, while the use of household detergents was associated with incident wheezing. The infants who displayed the most symptoms (nocturnal cough, excess bronchial secretions, respiratory distress) during their first year of life also had a higher risk of persistent wheezing. [Link to the article]
BCG vaccination before 3 months
Guthmann J-P., Ragot M., Ben Boutieb M., Bois C., Dufourg M-N., Levy Bruhl D., “Couverture vaccinale et déterminants socioéconomiques de la vaccination BCG chez l’enfant avant 3 mois: résultats de la cohorte Elfe, 2011”, Revue d’Epidémiologie et de Santé Publique, volume 64, no. 4, September 2016.
In line with recommendations, vaccine coverage is higher in Île-de-France (59.5%) than among at-risk children living outside this region (46.7%). Where both parents come from a country with a high rate of TB, coverage is 80.5% for children under 3 months in Île-de-France and 60.4% elsewhere. All other things being equal, vaccination is also more frequent among children who are followed by a paediatrician or in a mother-and-child healthcare centre. [Link to article]
Early prenatal interview and antenatal education
Barandon S., Balès M., Melchior M., Glangeaud-Freudenthal N., Pambrun E., Bois C., Verdoux H., Sutter-Dally A.-L., “Entretien prénatal précoce et séances de préparation à la naissance et à la parentalité: caractéristiques psychosociales et obstétricales associées chez les femmes de la cohorte Elfe”, Journal de Gynécologie Obstétrique et de Biologie de la Reproduction, August 2015.
The early prenatal interview (EPI) serves to identify the mental and physical health needs of couples and gauge their social environment during the perinatal period. The childbirth and parenting programme (BPP) provides health education.
Among the Elfe mothers, 33% had had an EPI and 52% had attended a BPP. Mothers who were expecting their first child, were born in France, had a high education level, or were in employment benefitted more often from an EPI and/or BPP, as did those who stated they had psychological problems. BPP attendance was lower among mothers who were young, had universal health coverage, ambivalent feelings towards their pregnancy, fewer than seven prenatal visits, or obstetric complications.
At present, the EPI and BPP mainly benefit populations with a higher socioeconomic status. They therefore need to be included in a system of prevention and broader healthcare in order to reach the most vulnerable populations and improve the social and psychological environment of all women during the perinatal period. [Link to article]
Tobacco and alcohol use during pregnancy in France: The role of migrant status
Melchior M., Chollet A., Glangeaud-Freudenthal N., Saurel-Cubizolles M.-J., Dufourg M.-N., van der Waerden J., Sutter-Dallay A.-L., “Tobacco and alcohol use in pregnancy in France: The role of migrant status: The nationally representative Elfe study”, Addictive Behaviors, 51:65-71, July 2015.
Analyses show that tobacco and alcohol use during pregnancy is higher among women born in France than among those born abroad (tobacco: 21.9 vs. 8.8%; alcohol: 40.4 vs. 22.9%). However, women born abroad who live alone have a particularly high probability of alcohol use. Disadvantaged socioeconomic status is associated with a higher level of tobacco use among women born in France, whereas the opposite trend is observed among women born abroad. Lastly, if the child’s father was born abroad, the mother will have low levels of tobacco and alcohol use regardless of whether she, too, was born abroad, suggesting that the features of the contact circle also play a role. [Link to article]
Psychological distress and access to mental healthcare during pregnancy
Bales M., Pambrun E., Melchior M., Glangeaud-Freudenthal N.-M., Charles M.-A., Verdoux H., Sutter-Dallay A.-L., “Prenatal psychological distress and access to mental health care in the ELFE cohort”, European Psychiatry, February 2015.
In the Elfe study, 12.6% of mothers stated that they had experienced psychological distress during their pregnancy. This distress was more frequent among women who had already had several pregnancies, used tobacco or alcohol, whose pregnancy was unplanned and unwanted, or who had had medical complications during pregnancy. Only 25% of the women who experienced prenatal psychological distress consulted a specialist. Younger women and women born abroad were those who sought professional help least often. Providing care for psychological distress during pregnancy would help women to prepare for the arrival of their child and avert problems arising from any persistent distress. [Link to article]
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