This was a hospital-based cross-sectional study of 224 randomly selected antenatal women receiving care at the University College Hospital, Ibadan, Nigeria. The study aimed to seek the attitude and preferences of respondents about social support during childbirth and also identify variables that may influence their decisions. Seventy-five per cent of respondents desired companionship in labour. Approximately 86% preferred their husband as companion while 7% and 5% wanted their mother and siblings as support person respectively. Reasons for their desire for social support were emotional (80·2%), spiritual (17·9%), errands (8·6%) and physical activity (6·8%). Socio-demographic variables found to be statistically significant on logistic regression analysis for the desire of a companion in labour were nulliparity (OR 3·57, 95% CI 1·49–8·52), professionals (OR 3·11, 95% CI 1·22–7·94) and women of other ethnic groups besides Yoruba (OR 2·90, 95% CI 1·02–8·26), which is the predominant ethnic group in the study area. Only those with post-secondary education were found to want their husbands as doula (OR 2·96, 95% CI 1·08–8·11). More than half of the respondents wanted information about labour prior to their experience. It is important that Nigerian women are allowed the benefit of social support during childbirth, particularly as there is a lack of one-to-one nursing care and other critical services, including epidural analgesia in labour, at many of the health care facilities in Nigeria. Men could play a pivotal role in the process of introducing support in labour so as to improve the outcome for both the mother and her newborn.

Child undernutrition is a major public health problem throughout the world, particularly in developing countries. The main objective of this study was to identify the risk factors for acute undernutrition among under-5 children in Bangladesh. Data were taken from the nationally representative Bangladesh Demographic Health and Survey conducted in 2014. The study sample comprised 7131 under-5 children. Of these, 4.6% were found to be severely wasted (Z-score < −3.0), 11.1% moderately wasted (−3.0≤Z-score < −2.0) and 84.3% adequately nourished (Z-score ≥−2.0). Chi-squared analysis was used to investigate the association between child nutrition status and selected covariates. Multinomial logistic regression was applied to identify the risk factors for acute undernutrition. The selected factors division, place of residence, sex of child, place of delivery, child age, respiratory illness, size at birth, measles vaccination, fever, diarrhoea, maternal BMI, maternal education, paternal occupation, wealth index and household toilet facilities were found to be highly significant (p < 0.05) in the analysis. Multinomial regression analysis revealed that residence in Barisal and Chittagong divisions, a smaller than average size at birth and low maternal BMI (≤18.50 kg/m2) were significant determinants of both moderate and severe acute undernutrition among under-5 children in Bangladesh.

The conventional view that childlessness was associated with higher than average risk of marital breakdown was questioned by Chester (1972) and Gibson (1980) on the basis of analysis of divorce records. Data from the 1980 General Household Survey are used to show that childless couples, and those who have children early in marriage (and are thus more likely to have large families) are considerably more at risk of breakdown at all marriage durations than delayed two-child families. The reasons for the different conclusions of these three studies are assessed and it is concluded that standardization has many unattractive features for demographic analysis (especially in areas other than mortality), and that presentations based on relative or absolute risk of breakdown allow the key features to be assessed most satisfactorily.

Human anthropometric traits, while significantly determined by genetic factors, are also affected by an individual’s early life environment. An adult’s body height is a valid indicator of their living conditions in childhood. Parental education has been shown to be one of the key covariates of individuals’ health and height, both in childhood and adulthood. Parental functional literacy has been demonstrated to be another important determinant of child health, but this has largely been overlooked in studies on height. The objective of this study was to analyse the associations between parents’ education, their functional literacy and their children’s adult body height. The study used data for 39,240 individuals from the 2016 wave of the nationally representative Life in Transition Survey (LITS) conducted in 34 countries in Southern and Eastern Europe, the Middle East and Central Asia. Using linear and Poisson models, regression adjustment treatment estimators and multilevel mixed-effects linear regressions, the study analysed the links between mother’s and father’s educational attainment, parental functional literacy, measured by the number of books in the childhood home, and children’s adult height. The models also included other individual and contextual covariates of height. The results demonstrated that mother’s educational attainment and parental functional literacy have independent associations with children’s adult body height. Sufficient literacy skills of the parent may have a positive effect on children’s growth even if parental education is low. These associations remained significant across time. The study also provides evidence of a widening of the height gap for men born in the period just before and after systemic transition in post-socialist societies, which may suggest an increase in social differences in early living standards.

The common belief that childlessness is positively associated with instability of marriage derives from official statistics which appear to show higher divorce rates for childless than for fertile couples. The official findings are a procedural artifact, however, and the relationship shown is certainly exaggerated and possibly spurious.

The appropriate strategy in determining whether divorcees are relatively infertile is to find a population with disrupted marriages and measure its fertility experience. In doing so it is necessary to take note of the definition of fertility, the remarriage factor, and (most importantly) the duration of marriage. The official statistics use the conception of legal duration of marriage. Since this ignores separation before divorce, its use exaggerates the infertility of divorcees, as does failure to exclude remarriages. De facto duration of marriage (wedding to separation) is a superior statement of opportunity to conceive, and calculations on this basis eliminate or even reverse the fertility differential between divorcing and stable couples. Local figures are used to illustrate this effect, and the finding is supported by evidence from a sample of marriages ending in legal proceedings lesser than divorce. It is concluded that the alleged relationship between childlessness and instability of marriage is probably either non-existent or the reverse of that normally assumed, and that in any case measurement of the net overall effect of childlessness does not provide a helpful datum. An alternative strategy of research is suggested, which would seek patterns of effect rather than net overall effect, taking heed of relevant variables, and also considering all forms of marital breakdown including marriages in which cohabitation continues only with disharmony.

Synchronous with the decline in fertility that took place in the post-war period in the Netherlands, patterns of birth seasonality changed as well. In this paper seasonal fluctuations in fertility in the Netherlands are examined using population register data for the period 1952 to 2005. The peak in births has changed from spring to summer and subsequently to August/September, thereby shifting from the European to the American pattern. The seasonal shift can be attributed to parity-specific changes. Before the transition, birth seasonality did not differ much between the different parities. In the transition period from higher to low fertility, differences between parities increased which persist up to today. At present, the overall seasonality pattern is determined by first births. Moreover, birth seasonality varies by maternal age. The findings stimulate the discussion on the role of planning as a cause of birth seasonality.

Globally, unplanned pregnancies and sexually transmitted infections (STIs) persist as significant threats to women’s reproductive health. Barriers to the use of modern contraceptives by women might inhibit uptake of novel woman-controlled methods for preventing STIs/HIV. Use of modern contraceptives and perceptions and attitudes towards contraceptive use were investigated among women in Antananarivo, Madagascar, using qualitative research. The hypothetical acceptability of the diaphragm – a woman-controlled barrier contraceptive device that also holds promise of protecting against STIs/HIV – was assessed. Women consecutively seeking care for vaginal discharge at a public health clinic were recruited for participation in a semi-structured interview (SSI) or focus group discussion (FGD). Audiotaped SSIs and FGDs were transcribed, translated and coded for predetermined and emerging themes. Of 46 participating women, 70% reported occasional use of male condoms, mostly for preventing pregnancy during their fertile days. Although women could name effective contraceptive methods, only 14% reported using hormonal contraception. Three barriers to use of modern contraceptives emerged: gaps in knowledge about the range of available contraceptive methods; misinformation and negative perceptions about some methods; and concern about social opposition to contraceptive use, mainly from male partners. These results demonstrate the need for programmes in both family planning and STI prevention to improve women’s knowledge of modern contraceptives and methods to prevent STI and to dispel misinformation and negative perceptions of methods. In addition, involvement of men will probably be a critical component of increased uptake of woman-controlled pregnancy and STI/HIV prevention methods and improved health.

This paper examines the seasonality of induced abortion in North Carolina between 1980 and 1993. Distinct seasonal patterns are found, with a peak in February and a valley in September. These patterns correspond to the implicit seasonality of conceptions associated with the seasonality of birth pattern. One notable difference from the general pattern is among unmarried women aged 18 and younger. They have the February peak and an additional peak in August that may be associated with the summer vacation from school.

Children's intelligence increased in the United States by approxi-mately 3 IQ points per decade over the period 1932–78. New evidence shows that these increases have been sustained during the last 20 years. Two recent studies indicate that the rates of increase for 1972–89 and 1978–89 were 3·3 and 3·5 IQ points per decade respectively.

The familiar and well-established negative association between a woman's age at marriage and family size has received somewhat less attention in recent years. No doubt this is because, with the reduction in fertility of the past century, the observed differentials appear less striking and seem less significant. Age at marriage is a less obvious determinant of family size than in the past. Glass & Grebenik (1954), commenting on the data produced by the 1946 Family Census, emphasized the decreasing importance of the association both absolutely and relatively. Contrasting the completed fertility of the 1900–09 and the 1925 marriage cohorts in Great Britain (Table 1), they argued that, though for all, married women the relative influence of age at marriage was unchanged, the figures for fertile marriages only (those where the wife had at least one child) appeared to indicate ‘that age at marriage and fertility were not quite so tightly linked for the more recent group’. And they added ‘this is the kind of development which would be expected with the increasing spread of family planning’.

This study examined the association between body composition, somatotype and socioeconomic status (SES) in Chilean children and adolescents by sex and school level (grade). The cross-sectional study was conducted on 1168 schoolchildren aged 6–18 years (572 males) from Valparaíso, Chile. Body composition, as assessed by percentage body fat (BF%) and somatotype, was evaluated using Ellis equations and the Heath–Carter method, respectively. The socioeconomic status of respondents was assessed using the ESOMAR survey. Obesity was defined as BF% ≥25 for boys and ≥30 for girls; ‘high endomorph’ somatotype was defined as a somatotype endomorph component (EC) of at least 5.5. Logistic regression analysis was used to assess the relationship between high adiposity and SES, potential confounding factors and school level. In females, the results indicated that the groups with lower SES had higher EC. At the 1st (youngest) school level (1–4th grades), males exhibited similar trends in their BF% and EC. High adiposity was associated with the female sex (BF%: OR=3.39; 95% CI 2.60, 4.41; high EC: OR=2.31; 95% CI 1.80, 2.98). In addition, low SES increased the risk of high adiposity compared with high SES (BF%: OR=2.25; 95% CI 1.40, 3.61; high EC: OR=2.19; 95% CI 1.37, 3.47). An association was observed between increased adiposity and lower SES, mainly in females, which indicates that females with low SES might be at greater risk of obesity.

This study was carried out in two medical facilities in Enugu, Nigeria, from September to November 2007. An interviewer-administered questionnaire was used to collect data from HIV-positive pregnant women accessing PMTCT (prevention of maternal-to-child transmission) services at the two centres. Ninety-two women were interviewed: 89 (96.7%) had disclosed their status, while 3 (3.3%) had not. Of the 89 women who had disclosed, 84 (94.4%) had disclosed to partners, 82 (92.1%) to husbands, 2 (2.2%) to fiancés, 18 (20.2%) to sisters, 13 (14.6%) to mothers, 10 (11.2%) to brothers, 10 (11.2%) to fathers and 10 (11.2%) to priests. Fifty-two (58.4%) gave emotional support as the reason for disclosure and 46 (51.7%) gave economic and financial support as reasons. Fifty-six (62.9%) reported understanding from partner as a positive outcome and 44 (49.4%) reported financial support. Forty-six (51.7%) reported no negative outcome. Serostatus disclosure rate in this study was high with most women disclosing to their partners.

The present paper is based on information on marital patterns and reproductive performance (reconstituted families) in the rural community of Los Nogales, Galicia, Spain. Biodemographic data were used to analyse temporal changes and structure of consanguinity in the population, as well as consanguinity versus reproductive success. Of 2347 marriages celebrated between 1871 and 1977, 5·15% were between relatives (up to third degree). The population’s inbreeding coefficient was above the Spanish average after 1890, and levels were high during the first part of the 20th century. A possible underestimation of inbreeding coefficients is attributed to the elevated frequency of extramarital births occurring in the Los Nogales population (13·47%). The structures of consanguineous matings, expressed as C22/C33 and C33/C44, turned out to be 0·86 and 0·82 respectively. Regarding migration, before 1920 consanguinity increased, but net migration was negative. In the period 1920–1929 consanguinity began to decrease, prior to maximum emigration. As for reproductive success, information from 1503 reconstituted families shows that complete fertility was slightly higher among consanguineous families despite a greater infant mortality. Lower infertility in consanguineous matings, as well as lower age at marriage and first maternity, could explain the above results.

A longitudinal study of twenty-six breast-feeding and twelve non-breast-feeding postpartum women was conducted in Assiut, Egypt in order to determine the time that ovulation resumed after childbirth, and the effect of breast-feeding frequency on the period of lactational anovulation. Breastfeeding women experienced the onset of follicular development, vaginal bleeding, ovulation and pregnancy significantly later than women who did not breast-feed. Ovulatory and non-ovulatory breast-feeders reported similar frequencies of breast-feeding episodes. The introduction of dietary supplements commonly preceded ovulation. An algorithm using three simple variables observable to the breast-feeding mother was found to predict up to 100% of the first ovulations. All breast-feeding women who did not give supplements and did not have a vaginal bleeding episode by 6 months postpartum were anovular by strict criteria for ovulation. Ovulation did not precede bleeding or supplementation in the women who experienced these events before 6 months, yielding a highly effective formula for preventing unplanned pregnancy by the informed use of breast-feeding.

The incidence of Down syndrome in Scotland between 1960 and 1974 was estimated using data from thirteen Area Health Boards. Incidences in individual years, in different months of the year and in different maternal age groups were also determined. There was an apparent increase in incidence in more recent years almost certainly due to increased ascertainment. This may have obscured any decrease in incidence which might be expected as a result of a decrease in mean maternal age during this period and the introduction of antenatal diagnosis. No seasonal differences in incidence could be detected either in the whole area or in individual Area Health Boards. There was an increase in incidence with maternal age which was not significantly different from that found by other investigators. There was also an indication of an increase in relative incidence (% Down syndrome births/% live births) over the period 1966–74 in mothers aged 35 years and older.

Birth seasonality responds to a variety of environmental and socio-cultural factors. The present study was carried out to quantify the trends in seasonal variation in birth rate in seven districts in the Kayes region of Mali between 2007 and 2010 and to attempt to link climatic- and agricultural-cycle-dependent factors with birth seasonality. Lagged regression analysis based on time series analysis techniques was used to investigate seasonality of births registered in health facilities and its association with climate, labour migration, agriculture workload, malaria infection and food supply. There was a clear bimodal pattern in month-to-month institutional delivery rate variation, and this seasonal pattern repeated each year over the study period. The data showed that rates of health-facility-attended deliveries were high at the end of the dry season (April–June), fell rapidly in the first half of the rainy season, rose again during the later part of the rainy season (August–October) and fell to their lowest values after the rains. The first peak observed in spring (April–June) corresponded to conception nine months earlier during the rainy season (between July and September), while the second peak observed in the third quarter of the year (August–October) corresponded with conception at the beginning of the dry season right after the harvest period (between November and January). Between these peaks was an abrupt trough in July. The findings support a causal process through which climate change influences conception/birth seasonality in two direct and indirect pathways. On one side climate change influences conception/birth seasonality from the effects on fetal loss (changes in annual rainfall leading to changes in malaria incidence) and on the other side by affecting fecundability (changes in agricultural cycles leading to changes in food production, agricultural workload and socio-cultural events, which in turn influence energy balance and sexual behaviour). Labour migration, which is closely linked with the agricultural cycle, influences sexual intercourse and thus marital fertility. Finally, the model emphasizes an ecosystemic approach to the study of birth seasonality.

Human breast milk is primarily colostrum immediately following birth. Colostrum gradually changes to mature milk over the next several days. The role of colostrum in fighting infections and promoting growth and development of the newborn is widely acknowledged. This role is mediated by differences across cultures in the acceptability of colostrum and the prevalence of colostrum feeding. This study examined the prevalence of colostrum feeding and time to initiation of breast-feeding in 143 rural Bangladeshi women in Matlab thana. Structured interviews were collected during a 9-month prospective study conducted in 1993. Women were usually interviewed within 4 days of giving birth and were asked about whether or not they fed their child colostrum and the number of hours until they began breast-feeding the baby. Ninety per cent of the mothers reported feeding their newborn colostrum. A logistic regression found no effect on the prevalence of colostrum feeding from the following covariates: mother's age, parity, history of pregnancy loss, child's sex, mother's self-report of delivery complications, and the time from birth to interview. Fifty-nine per cent of mothers initiated breast-feeding within 4 h, and 88% within 12 h of parturition. Survival analysis was used to estimate the effects of covariates on the time from delivery to initial breast-feeding. Time to initial breast-feeding was delayed slightly, but significantly, for older mothers, for male infants, and by mothers who did not report delivery complications. The percentage of mothers who fed their child colostrum was higher, and times to initial breast-feeding were shorter, than almost all previous reports from South Asia. These findings might be explained, in part, by methodological differences among studies, but it is suggested that recent changes towards earlier initiation of breast-feeding have taken place in rural Bangladesh.

Hypertension is one of the primary causes of morbidity and premature mortality among the working-age population in India. This study evaluated the burden of hypertension and unmet need for hypertension care among working-age men aged 15–54 years in India using data from the fourth round of the National Family Health Survey (NFHS-4, 2015–16). An individual was recognized as hypertensive if his blood pressure was over 140/90 mmHg or if he was consuming anti-hypertensive medication to lower his blood pressue. The study design was based on the Rule of Halves framework. Hypertensive cases were segmented into five analytical levels: (1) total, (2) screened, (3) diagnosed, (4) treated and (5) controlled cases. The prevalence of hypertension was 16% (n=16,254) among the men aged 15–54 years. Of the total hypertensive individuals, 63.2% (10,314) were screened, 21.5% (3428) were diagnosed, 12.6% (1862) were treated and only 6.1% (905) had controlled blood pressure. Of the screened individuals, 66.8% (6886) had never been diagnosed, 45.7% (1566) of those diagnosed had not receive treatment and 51.4% (957) of those treated still had uncontrolled blood pressure. The analyses revealed that 36.5% (5940) of hypertensive individuals were lost at the screening stage. The results demonstrate that there is a significant burden of hypertension and unmet need for hypertension care among men aged 15–54 in India. There is an urgent need to develop suitable strategies and programmes to manage this rising burden of hypertension among men, and reduce losses in the hypertension care continuum.

Ten narrative studies involving family histories of 262 children of gay fathers and lesbian mothers were evaluated statistically in response to Morrison's (2007) concerns about Cameron's (2006) research that had involved three narrative studies. Despite numerous attempts to bias the results in favour of the null hypothesis and allowing for up to 20 (of 63, 32%) coding errors, Cameron's (2006) hypothesis that gay and lesbian parents would be more likely to have gay, lesbian, bisexual or unsure (of sexual orientation) sons and daughters was confirmed. Percentages of children of gay and lesbian parents who adopted non-heterosexual identities ranged between 16% and 57%, with odds ratios of 1.7 to 12.1, depending on the mix of child and parent genders. Daughters of lesbian mothers were most likely (33% to 57%; odds ratios from 4.5 to 12.1) to report non-heterosexual identities. Data from ethnographic sources and from previous studies on gay and lesbian parenting were re-examined and found to support the hypothesis that social and parental influences may influence the expression of non-heterosexual identities and/or behaviour. Thus, evidence is presented from three different sources, contrary to most previous scientific opinion, even most previous scientific consensus, that suggests intergenerational transfer of sexual orientation can occur at statistically significant and substantial rates, especially for female parents or female children. In some analyses for sons, intergenerational transfer was not significant. Further research is needed with respect to pathways by which intergenerational transfer of sexual orientation may occur. The results confirm an evolving tendency among scholars to cite the possibility of some degree of intergenerational crossover of sexual orientation.

Consanguinity is studied in a large sample of marriages among Dhangars of Maharashtra, India. The 22 endogamous castes included in the study show great variation in incidence, about an overall frequency of 26.4%. Matrilateral first cross-cousin unions are more frequency than patrilateral, and maternal uncle-niece nuions least frequent. Geograbhical differences are conspicuous, and all three types of consanguineous union show characteristic patterns; matrilateral unions increase in frequncy northwards, patrilateral and uncle-niece decrease northwards. The inbreeding levels among the Dhangars are high compared to other Maharashtrian groups, but substantially lower than in southern Dravidian speaking groups.