Both preterm birth and low birth weight (LBW) represent major public health problems worldwide due to their association with the catastrophic effects of morbidity and mortality. Few data exist about such adverse pregnancy outcomes. The current study aimed to investigate the prevalence of and factors associated with preterm birth and LBW among mothers of children under two years in Abu Dhabi, United Arab Emirates. Data were collected in clinical and non-clinical settings across various geographical areas in Abu Dhabi. The data were analyzed using both descriptive and inferential statistics. A total of 1610 mother–child pairs were included in the current study. Preterm birth rate was 102 (6.3%) with a 95% confidence interval [CI] (6.1%, 6.5%) and the LBW rate was 151 (9.4%) with a 95% CI (9.3%, 9.5%). The mean (SD) of gestational age (GA) and birth weight at delivery was 39.1 (1.9) weeks and 3080.3 (518.6) grams, respectively. Factors that were positively associated with preterm birth were Arab mothers, maternal education level below secondary, caesarean section, and LBW. LBW was associated with female children, caesarean section (CS), first child order, and preterm birth. The current study highlighted the need for further interventional research to tackle these public health issues such as reducing the high CS rate and improving maternal education.

Introduction Despite the enormous benefits of breastfeeding, working mothers face more challenges to meet the World Health Organization (WHO) recommendations regarding successful breastfeeding practices. Little research has been done to understand the breastfeeding practices among working mothers in the United Arab Emirates (UAE). Thus, the aim of this study was to investigate the prevalence and factors associated with delayed initiation and cessation of breastfeeding among working mothers with children under the age of two years in Abu Dhabi, the UAE. Methods A cross-sectional multicenter study was conducted from March to September 2017. The study included both Emirati and non-Emirati mothers of children below the age of two years. The data were collected from seven government health care centers in Abu Dhabi as well as from the community. Mothers with young children attending the centers during the study days were approached by trained research assistants, who provided oral and written information about the study. Results Among the 1610 mother–child pairs with complete data who were included in this study, 606 were working mothers giving an employment rate of 37.6%. The mean (standard deviation) of maternal age and children’s age were 30.9 (5.1) years and 8.6 (6.1) months, respectively. Of the 606 mothers, 217 (35.8%) delayed initiation of breastfeeding, and 359 (59.2%) ceased breastfeeding. In multivariable logistic regression analysis, factors associated with delayed breastfeeding initiation among working mothers were older mother age (adjusted odds ratio [AOR] 1.04, 95% confidence interval [CI]1.01, 1.08), being of non-Arab nationality (AOR 2.24, 95% CI 1.53, 3.27), caesarean section (AOR 2.70, 95% CI 1.84, 3.96), non-rooming-in (AOR 3.85, 95% CI 1.56, 9.51) and mothers with low birth weight children (AOR 2.47, 95% CI 1.23, 4.94). The main factors associated with cessation of breastfeeding were being of non-Arab nationality (AOR 1.59, 95% CI 1.09, 2.31) and mother with high-income rating (AOR 2.79, 95% CI 1.36, 5.75). Conclusion The study highlighted the need for urgent actions to improve the working mothers’ conditions in order to promote optimal breastfeeding practices, including both early initiation and continuation of breastfeeding among all mothers in the UAE regardless of employment status. Policies to improve EBF rates among professional working mothers should include maternity leave extension to enable mothers to continue breastfeeding.

The World Health Organization (WHO) recommends the early initiation of breastfeeding. Research shows that factors such as mode of delivery may interfere with the early initiation of breastfeeding. However, data in the United Arab Emirates (UAE) on these findings is limited. Thus, the aim of this study was to describe the prevalence of caesarean sections (CSs) and evaluate their effect on breastfeeding initiation among mothers of children under the age of two years in Abu Dhabi. Data were collected in clinical and non-clinical settings across various geographical areas in Abu Dhabi during 2017 using consent and structured questionnaires for interviews with mothers. Data analysis included both descriptive and inferential statistics. Among the 1624 participants, one-third (30.2%) reportedly delivered by CS, of which 71.1% were planned, while 28.9% were emergency CS. More than half of all mothers (62.5%) initiated early breastfeeding. Multivariable logistic regression indicated factors that were associated positively with CS included advanced maternal age, nationality, and obesity. However, gestational age (GA) was negatively associated with CS. This study shows that the prevalence of CS is high in Abu Dhabi, UAE. CS is associated with lower early initiation rates of breastfeeding. The early initiation rates of breastfeeding were 804 (79.2%) 95% confidence interval (CI) (76.4, 82.0), 162 (16.0%) 95% CI (10.4, 21.6), and 49 (4.8%) 95% CI (1.2, 10.8) among vaginal delivery, planned CS, and emergency CS, respectively. Regarding the mode of delivery, vaginal were 2.78 (Adjusted Odd Ratio (AOR)): CI (95%), (2.17–3.56, p < 0.001) times more likely related to an early initiation of breastfeeding. CS in general, and emergency CS, was the main risk factor for the delayed initiation of breastfeeding. The study provides valuable information to develop appropriate strategies to reduce the CS rate in UAE. Maternal literacy on CS choices, the importance of breastfeeding for child health, and additional guidance for mothers and their families are necessary to achieve better breastfeeding outcomes.

Objectives This integrative review examines health literacy research in the Eastern Mediterranean Region (EMR) and describes: (1) assessments and screening tools used to measure levels of health literacy, and (2) the focus, methods, and findings of health literacy research in the region. Methods A total of 246 records were identified through a systematic search of online databases from 1950 to 2017, to include: ProQuest Middle East and Africa, MEDLINE, PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic OneFile, Web of Science, Scopus, and Google Scholar. The final sample included 49 full-text articles. Results This research described 7 studies which used existing or new health literacy measures. Levels of health literacy in the EMR were similar to those for Europe and the United States. Low health literacy in EMR countries was more prevalent among females than males. The relationships between health literacy and knowledge, behavior and health outcomes varied across countries. Conclusions To our knowledge, this study is the first in the EMR. Appropriately designed studies should better define health literacy needs due to variations in socioeconomic status within subregions. Future health literacy measures must consider stronger psychometric properties to guide development and validation.

Background The overwhelming majority of United Arab Emirates (UAE) school-aged children do not meet the 60 min per day recommendation of moderate-to-vigorous physical activity (MVPA). Understanding the different school day segments contribution to children reaching this goal is a crucial step toward developing successful strategies to promote school day MVPA levels. This study aimed to objectively measure children’s’ physical activity levels and to examine the difference in physical activity levels between high active and low active children during the school day in Abu Dhabi. Methods A total of 133 school children (56% boys; mean age 10.5 years; grades 4–7) from two elementary schools in Abu Dhabi wore accelerometers (ActiGraph GT9X Link) for up to 5 non-consecutive days during spring 2019. Children’s’ MVPA was estimated during the following school segments: class time, lunch, recess, physical education (PE), and whole school day. Children were stratified as “high active” meeting the ≥30 min/day MVPA school time guideline or “low active” accumulating < 30 min/day MVPA. Results On average children accumulated 21.8 ± 22.6 min/day of MVPA on PE days and 22.4 ± 15.9 min/day of MVPA on non-PE days. Only 19% of children met the 30 min or more of school day MVPA recommendation, with higher proportion of boys (27%) meeting such recommendation compared to girls (8%). High active boys, spent the highest percent of time in MVPA during PE (28%), followed closely by lunch (27%). In compression, high active girls spent the highest percent of time in MVPA during lunch (14.2%) followed by recess (9.1%). High active children accumulated 15.06 more minutes of MVPA during PE (p < 0.001), 2 more minutes during recess (p < 0.001), 3 more minutes of MVPA during lunch (p < 0.001) and 5 more minutes of MVPA during class time (p < 0.001). Conclusion The overwhelming majority of school children did not meet the recommended 30 min /day MVPA during school time. Girls substantially accumulated less MVPA and more sedentary minutes across all segments during the school days compared to boys. Further research is needed to investigate school day segments contribution to children MVPA in the UAE.

The World Health Organization (WHO) recommends rooming-in to reduce infant mortality rates. Little research has been done to assess practices such as rooming-in and its relation to breastfeeding in the United Arab Emirates (UAE). The aim of this study was to examine the prevalence of rooming-in during hospital stay among mothers with infants six months old and below, in addition to other associated factors in Abu Dhabi, UAE. This study utilized a sub-sample extracted from a dataset based on a convenience sample of mothers who were recruited from governmental maternal and child health centers as well as from the community. The purpose of the original research was to evaluate infant and young children’s feeding practices. A pre-tested questionnaire was used during interviews with mothers once ethical clearance was in place. Multivariable logistic regression was conducted to describe the results. The original sample included 1822 participants, of which 804 infants met the inclusion criteria. The mean age for mothers and infants was 30.3 years and 3.5 months, respectively. The rate of rooming-in during hospital stay was 97.5%. Multivariable logistic regression analysis indicated factors associated with not rooming-in were low maternal age (Adjusted Odds Ratios (AOR) = 1.15, 95% confidence interval (CI): 1.03, 1.30), low gestational age (GA) (AOR = 1.90, 95% CI: 1.52, 2.36), abnormal pre-pregnancy body mass index (BMI) (AOR = 3.77, 95 % CI: 1.22, 11.76), and delayed initiation of breastfeeding (AOR = 4.47, 95 % CI: 1.08, 18.48). In the context of the high rate of rooming-in revealed in this study, there should be a focus on those groups who do not room-in (i.e., younger women and those with babies of a younger gestational age). Rooming-in practice provides self-confidence in taking care of a baby, knowledge about breastfeeding, and stimulates early-phase lactation.

Aim: In the Middle East where nutrition-related diseases continue to be on the rise, health literacy related research may provide meaningful insight to patientprovider communication, nutrition and general health behavior, to improve health outcomes. Yet, little is known about health literacy in the region. We provide insight into the current research on health literacy and nutrition-related outcomes in the region. Methods: English-language articles were identified using relevant keywords to search PubMed, Medline, Web of Science, and ProQuest Middle East & African.Inclusion criteria were quantitative and qualitative studies of any design focused on health literacy and nutrition-related health outcomes in the Middle East. We identified 22 unduplicated articles that met inclusion criteria. Results: To date, only three studies employ a validated health literacy measure to examine the relationship between health literacy and nutrition-related disease outcomes (e.g., diabetes, overweight, and obesity). However, the research findings from the three studies

BACKGROUND: Early initiation of breastfeeding is important for good lactation outcomes and has long been recommended by the World Health Organization. Recommendations are based on research showing that breastfeeding saves children’s lives, particularly among vulnerable populations such as low birth weight (LBW) neonates. In spite of a consistent rise in LBW deliveries, and in spite of the importance of breastfeeding for the survival of LBW neonates, a dearth of research exists regarding early initiation of breastfeeding for this population. AIM: The aim of this study was to investigate the prevalence of, and factors associated with the initiation of breastfeeding among mothers with children aged <2 years who were LBW in Abu Dhabi, United Arab Emirates (UAE). METHODS: The data for this cross-sectional study were extracted from a larger project on the evaluation of breastfeeding practices in Abu Dhabi. The original data were collected from seven health-care centers located in different urban and suburban areas of Abu Dhabi during 2017. A structured questionnaire was used by trained research assistants who collected relevant data from mothers during the interview. RESULTS: The study included a total of 1822 mothers of children below the age of 2 years; 175 (9.6%) of those children were identified as LBW. The mean standard deviation [SD] ages of the mothers and the children were 30.5 (5.0) years and 6.0 (5.1) months, respectively. The mean birth weight (SD) of the LBW children was 2079.6 (255.0) grams. Forty (29.9%) mothers of LBW children initiated breastfeeding within the 1 st h. Sixty-four (47.8%) were delivered vaginally, and 70 (52.2%) were delivered through cesarean section (CS). In multivariable logistic regression analysis, the only factor associated with delayed initiation of breastfeeding among the LBW children was CS (adjusted odds ratio 2.33; 95% confidence interval 1.07, 5.07). CONCLUSION: The prevalence of LBW was 9.6%, and it was associated with delayed initiation of breastfeeding as compared to the normal birth weight babies. While early initiation of breastfeeding should be promoted for all newborns, LBW infants are recognized as a vulnerable group and thus require additional support. There should be more emphasis on promoting and facilitating breastfeeding for LBW babies, especially those delivered by CS.