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1.
ObjectivesThis study examines the relationship between exposure to incarceration and food insecurity among mothers during pregnancy. MethodsUsing data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2004 to 2015, logistic regression models were used to assess the association between incarceration of a woman or her partner in the year before birth and the likelihood of experiencing food insecurity. ResultsNet of control variables, exposure to incarceration either personally or vicariously through a partner is associated with a 165% increase in the odds of food insecurity (OR 2.65, CI 2.29, 3.08). Attenuation analyses indicate this association partly operates through financial hardship, maternal unemployment, and receiving WIC benefits. Conclusions for PracticeGiven the adverse consequences of food insecurity for maternal health and early childhood development, public health and criminal justice practitioners should develop targeted interventions to alleviate the negative repercussions associated with exposure to incarceration among pregnant women. 相似文献
2.
Objective The purpose of this study was to examine the association between prenatal smoking and small for gestational age (SGA) infants among adolescent women in West Virginia, taking into account sociodemographic and health-related factors. Methods Secondary data analysis was conducted using the 2005–2010 West Virginia Pregnancy Risk Assessment and Monitoring Systems weighted dataset. The study population using complete case analysis procedure consisted of 886 adolescent women ages 19 and younger who delivered a live singleton infant in West Virginia. Results The prevalence of smoking among adolescents during the last 3 months of pregnancy was 67 %. Nearly a quarter (22.0 %) of the adolescents gave birth to SGA infants. Results from the logistic regression analysis showed that after controlling for sociodemographic and health-related variables, adolescents who smoked during the last 3 months of pregnancy were more likely to have SGA infants than those who did not smoke during the last 3 months of pregnancy (OR = 1.86, 95 % CI 1.06–3.27, P = 0.0307). Conclusion This study highlights the importance of recognizing that prenatal smoking is an issue among West Virginia adolescents and the need for evidence-based, culturally, and developmentally appropriate interventions for this Appalachian population. 相似文献
3.
Maternal and Child Health Journal - Hypertensive disorders of pregnancy have lifelong implications on maternal cardiovascular health. Breastfeeding has a variety of maternal benefits, including... 相似文献
4.
Postpartum depression affects 10–20% of women and causes significant morbidity and mortality among mothers, children, families,
and society, but little is known about postpartum depression among the individual Asian and Pacific Islander racial/ethnic
groups. This study sought to indentify the prevalence of postpartum depression among common Asian and Pacific Islander racial/ethnic
groups. Data from the Hawaii Pregnancy Risk Assessment and Monitoring System (PRAMS), a population-based surveillance system
on maternal behaviors and experiences before, during, and after the birth of a live infant, were analyzed from 2004 through
2007 and included 7,154 women. Questions on mood and interest in activities since giving birth were combined to create a measure
of Self-reported Postpartum Depressive Symptoms (SRPDS). A series of generalized logit models with maternal race or ethnicity
adjusted for other sociodemographic characteristics evaluated associations between SRPDS and an intermediate level of symptoms
as possible indicators of possible SRPDS. Of all women in Hawaii with a recent live birth, 14.5% had SRPDS, and 30.1% had
possible SRPDS. The following Asian and Pacific Islander racial or ethnic groups were studied and found to have higher odds
of SRPDS compared with white women: Korean (adjusted odds ratio [AOR] = 2.8;95% confidence interval [CI]: 2.0–4.0), Filipino
(AOR = 2.2;95% CI: 1.7–2.8), Chinese (AOR = 2.0;95% CI: 1.5–2.7), Samoan (AOR = 1.9;95% CI: 1.2–3.2), Japanese (AOR = 1.6;95%
CI: 1.2–2.2), Hawaiian (AOR = 1.7;95% CI: 1.3–2.1), other Asian (AOR = 3.3;95% CI: 1.9–5.9), other Pacific Islander (AOR = 2.2;95%
CI: 1.5–3.4), and Hispanic (AOR = 1.9;95% CI: 1.1–3.4). Women who had unintended pregnancies (AOR = 1.4;95% CI: 1.2–1.6),
experienced intimate partner violence (AOR = 3.7;95% CI: 2.6–5.5), smoked (AOR = 1.5;95% CI: 1.2–2.0), used illicit drugs
(AOR = 1.9;95% CI: 1.3–3.9), or received Women, Infant, and Children (WIC) benefits during pregnancy (AOR = 1.4;95% CI: 1.2–2.6)
were more likely to have SRPDS. Several groups also were at increased risk for possible SRPDS, although this risk was not
as prominent as seen with the risk for SRPDS. One in seven women reported SRPDS, and close to a third reported possible SRPDS.
Messages about postpartum depression should be incorporated into current programs to improve screening, treatment, and prevention
of SRPDS for women at risk. 相似文献
5.
Objective: This study examines whether unintended pregnancy is associated with physical abuse of women occurring around the time of pregnancy, independent of other factors. Methods: In 1996–1997, state-specific population-based data were obtained from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 39,348 women in 14 states who had delivered a live-born infant within the previous 2–6 months. The study questionnaire asked about maternal behaviors and characteristics around the time of pregnancy. Results: Women who had mistimed or unwanted pregnancies reported significantly higher levels of abuse at any time during the 12 months before conception or during pregnancy (12.6% and 15.3%, respectively) compared with those with intended pregnancies (5.3%). Higher rates of abuse were reported by women who were younger, Black, unmarried, less educated, on Medicaid, living in crowded conditions, entering prenatal care late, or smoking during the third trimester. Overall, women with unintended pregnancies had 2.5 times the risk of experiencing physical abuse compared with those whose pregnancies were intended. This association was modified by maternal characteristics; the association was strongest among women who were older, more educated, White, married, not on Medicaid, not living in crowded conditions, receiving first trimester prenatal care, or nonsmoking during the third trimester. Conclusions: Women with unintended pregnancies are at increased risk of physical abuse around the time of pregnancy compared with women whose pregnancies are intended. Prenatal care can provide an important point of contact where women can be screened for violence and referred to services that can assist them.The Pregnancy Risk Assessment Monitoring System (PRAMS) Working Group comprises the following state collaborators:L. Albert Woolbright, Alabama; Kathy Perham-Hester, Alaska; Gina Redford, Arkansas; Darci Cherry, Colorado; Richard Hopkins, Florida; Leslie Lipscomb, Georgia; Martha Henson, Maine; Yasmina Bouraoui, Michigan; Michael Medvesky, New York; Michelle Beck-Warden, North Carolina; Richard Lorenz, Oklahoma; Kriisten Helms, South Carolina; Linda Lohdefink, Washington; and Melissa Baker, West Virginia 相似文献
6.
Objective: To assess trends in prenatal discussions about HIV testing and prenatal HIV testing during the period 1996–2001. Methods: Using data from the Pregnancy Risk Assessment Monitoring System, a population-based postpartum survey of women, we calculated
the self-reported prevalences of discussion of prenatal HIV testing and testing. Data were analyzed using SUDAAN; trends were
calculated by logistic regression for states having ≥3 years of data. Results: From 1996 to 2001, significant increases in prenatal discussions about HIV testing were seen in 15 of 17 states. During the
period 1996–2001, the prevalence of testing increased significantly in 7 of 8 states. In all states, there was a significant,
positive relationship between having a prenatal discussion about testing and having an HIV test (odds ratios ranged from 1.7
to 4.9). Conclusions: We found statistically significant increases in discussions and testing from 1996 through 2001, consistent with guidelines
emphasizing routine prenatal testing. Health care providers may have a strong influence on women’s decisions to be tested.
Because current guidelines call for simplified strategies to reduce barriers to universal prenatal HIV screening, trends in
prenatal HIV testing should continue to be monitored to assess the impact of these changes. 相似文献
7.
Objectives Prenatal care (PNC) is a critical preventive health service for pregnant women and infants. While timely PNC has been associated with improved birth outcomes, improvements have slowed since the late 1990s. Therefore, focus has shifted to interventions prior to pregnancy. Preconception care is recommended for all women of reproductive age. This study aimed to examine preconception care and its association with timeliness and adequacy of PNC. Methods This retrospective cohort study used data from a large sample of United States first-time mothers (n?=?13,509) who participated in the 2009–2011 Pregnancy Risk Assessment Monitoring System in ten states. Timeliness and adequacy of PNC data came from birth certificates, while preconception care receipt was self-reported. Logistic regression provided odds ratios (ORs) and 95% confidence intervals (CIs) to model the association between preconception care receipt and the two PNC outcomes. Results After adjustment, women who received preconception care had statistically significant increased odds of timely (OR 1.30, 95% CI 1.08, 1.57), but not adequate PNC (OR 1.08, 95% CI 0.94, 1.24) as compared to women who did not receive preconception care. Pregnancy intention modified these associations. Associations were strongest among women with intended pregnancies (timely PNC: OR 1.63 and adequate PNC: OR 1.22). Conclusions for Practice Given that untimely PNC is associated with adverse birth outcomes, the observed association warrants increased focus on implementing preconception care. Future studies should investigate how specific components of preconception care are associated with PNC timeliness/adequacy, health behaviors during pregnancy, and birth outcomes. 相似文献
8.
BackgroundRacial disparities in birth outcomes represent a significant public health concern in the United States. Factors associated with racism have been posited as a mechanism underlying these disparities. Yet, findings from previous studies are mixed and based on small, geographically limited samples. This study aims to examine the relationship between experiences of racism and preterm birth in a population-based sample and to explore the role of adequacy of prenatal care within that relationship.MethodsData from the 2004 through 2012 Pregnancy Risk Assessment Monitoring System were analyzed. The sample included non-Hispanic Black mothers from 11 states and New York City who delivered neonates from 2004 to 2012 (n = 11,582). Survey-weighted regression analyses were used to examine the association between women feeling upset by experiences of racism in the 12 months before delivery and subsequent preterm birth. Adequacy of prenatal care was tested as an effect modifier.ResultsFeeling upset by experiences of racism was significantly associated with greater odds of preterm birth (adjusted odds ratio, 1.29; 95% CI, 1.04–1.59). Results from interaction models revealed that the associations of experiences of racism with preterm birth differed by level of prenatal care, although the interaction term was not significant.ConclusionsFindings suggest that, for non-Hispanic Black women, the emotional effect of experiences of racism may contribute to the risk of preterm birth. Future studies should consider the role of adequate prenatal care in this relationship. Racism is an important public health problem with a measurable impact on preterm birth and should be addressed to eliminate racial inequities in birth outcomes. 相似文献
9.
BackgroundCurrent U.S. guidelines recommend consideration of nicotine replacement therapy (NRT) for pregnant smokers if behavioral therapies fail, only under close supervision of a provider, and after discussion of known risks of continued smoking and possible risks of NRT. The percentage of pregnant smokers offered NRT by their prenatal care providers is unknown. PurposeThe study aims to calculate the percentage of pregnant smokers offered cessation intervention and NRT and assess independent associations between selected maternal characteristics and being offered NRT. MethodsData were analyzed from the 2009–2010 Pregnancy Risk Assessment Monitoring System from four states that asked about provider practices for prenatal smoking cessation. Adjusted prevalence ratios were calculated to examine associations between being offered NRT, selected maternal characteristics, and smoking level. Variables used in adjusted models were based on factors associated with smoking cessation during pregnancy from prior literature and included race, age, education, insurance type, and stress. ResultsOf 3559 women who smoked 3 months before pregnancy, 77.4% (95% CI: 74.2, 80.3) of 3rd trimester smokers and 42% (95% CI: 38.5, 46.4) of women who quit smoking during pregnancy were offered at least one cessation method. Among smokers, 19.1% (95% CI: 16.5, 22.1) were offered NRT and of these, almost all (94%) were offered another cessation method. ConclusionsOne in five pregnant smokers was offered NRT. About a quarter of pregnant smokers did not receive any interventions to stop smoking. There may still be reluctance to provide NRT to pregnant women, despite known harms of continued smoking during pregnancy. 相似文献
11.
We investigated the association between 2009 IOM recommendations and adverse infant outcomes by maternal prepregnancy body
mass index (BMI). Birth outcomes for 570,672 women aged 18–40 years with a singleton full-term live-birth were assessed using
2004–2007 Florida live-birth certificates. Outcomes included large-for-gestational-age (LGA) and small-for-gestational-age
(SGA). Associations between gestational weight change and outcomes were assessed for 10 BMI groups by calculating proportions,
and logistic regression modeling was used to produce adjusted odds ratios (aORs) to account for the effect of confounders.
We created comparison categories below and above recommendations using 2009 IOM recommendations as a reference. Of importance,
41.6% of women began pregnancy as overweight and obese and 51.2% gained weight excessively during pregnancy on the basis of
2009 IOM recommendations. Proportions of LGA were higher among obese women and increased with higher weight gain. Compared
with recommended weight gain, aORs for LGA were lower with less than recommended gain (aOR range: 0.27–0.77) and higher with
more than recommended gain (aOR range: 1.27–5.99). However, SGA was less prevalent among obese women, and the proportion of
SGA by BMI was similar with higher weight gain. Gain less than recommended was associated with increased odds of SGA (aOR
range: 1.11–2.97), and gain greater than recommended was associated with decreased odds of SGA (aOR range: 0.38–0.83). Gestational
weight gain influenced the risk for LGA and SGA in opposite directions. Minimal weight gain or weight loss lowered risk for
LGA among obese women. Compared with 1990 IOM recommendations, 2009 recommendations include weight gain ranges that are associated
with lower risk of LGA and higher risk of SGA. Awareness of these tradeoffs may assist with clinical implementation of the
2009 IOM gestational weight gain recommendations. However, our results did not consider other maternal and infant outcomes
related to gestational weight gain; therefore, the findings should be interpreted with caution. 相似文献
12.
PurposeOne-third of all pregnancies in the United States are conceived within 18 months of a prior live birth. Preventing unintended pregnancies may help to decrease the prevalence of pregnancies with these short interpregnancy intervals. However, data on factors associated with pregnancy intention among women who have had short birth intervals are sparse. Pregnancy Risk Assessment Monitoring System data were used to further evaluate these associations.MethodsBecause only Mississippi and Tennessee Pregnancy Risk Assessment Monitoring System include a survey question about birth interval length, this analysis was limited to women from those states who recently had a short birth interval (n = 384). Pregnancy intention and demographic, lifestyle, and reproductive data were obtained from surveys and birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs).ResultsNearly 76% of women with short birth intervals reported their pregnancy as unintended. Women who were non-Hispanic black or consumed alcohol during pregnancy had statistically significant increased odds of reporting the pregnancy with a short birth interval as being unintended (OR = 3.98; 95% CI: 1.73–9.16 and OR = 10.56; 95% CI: 1.80–61.83, respectively).ConclusionsAlthough all women should be counseled on postpartum contraceptive use, findings suggest that important subpopulations of women may benefit from more targeted counseling during prenatal care visits and the immediate postpartum hospital stay regarding the importance of using contraception to not only better space pregnancies but also prevent unintended pregnancies. 相似文献
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