Dental Cleaning Before and During Pregnancy Among Maryland Mothers

Despite increasing recognition of the importance of oral health to overall health, dental care utilization remains low in the US. Given the established link between maternal oral health and child oral health, this study examined factors related to preventive dental care utilization at two critical time points, before and during pregnancy. Data were obtained from a sample of 6,171 women who delivered a live birth during 2004–2008 and completed the Maryland Pregnancy Risk Assessment Monitoring System postpartum survey. Multinomial logistic analyses examined associations between predisposing and enabling factors with dental cleaning before and during pregnancy. Women with less than a high school education or a history of physical abuse and non-Hispanic black and Hispanic women were less likely to report teeth cleaning before and during pregnancy. Having no insurance at the start of pregnancy was associated with significantly lower risk of teeth cleaning before pregnancy and both before and during pregnancy. Receipt of oral health counseling during pregnancy was positively related to teeth cleaning during pregnancy. Dental cleaning is associated with insurance, oral health counseling and maternal factors such as race, ethnicity, education and history of physical abuse. Better integration of oral health into prenatal health care, particularly among ethnic and racial minority groups, may be beneficial to maternal and infant well-being. Oral health promotion, disease prevention and health care should be a part of the local, state and national health policy agendas.     

Birth Outcomes,Postpartum Health and Primary Care Contacts of Immigrant Mothers in an Australian Nulliparous Pregnancy Cohort Study

To investigate differences and similarities in birth outcomes, postpartum health and primary care contacts of mothers born overseas of non-English speaking background (NESB) compared with Australian-born mothers. Nulliparous women were recruited in early pregnancy (≤24 weeks gestation) to a prospective pregnancy cohort study from six metropolitan public hospitals in Victoria, Australia. Analyses are based on questionnaires completed in pregnancy and at 3 months postpartum. Of the 1,507 women recruited in the study, 1,431 women (95%) were followed up at 3 months postpartum. Immigrant mothers of NESB (n = 212) and Australian born mothers (n = 1,074) had similar obstetric outcomes and postpartum physical health outcomes. Immigrant women were more likely to say they had been depressed for 2 weeks or longer since the birth (Adj OR = 1.92, 95% CI 1.3–2.8); to report relationship problems (Adj OR = 1.39, 95% CI 0.9–2.1) and to report lower emotional satisfaction with their relationship with the partner (Adj OR = 1.69, 95% CI 1.1–2.6) after adjusting for age, education status, income, method of birth and genital tract trauma. Immigrant mothers were less likely to be asked about feeling low or depressed by general practitioners (OR = 0.79, 95% CI 0.5–0.9) and about relationship problems by maternal and child health nurses (OR = 0.68, 95% CI 0.5–0.9). Immigrant women of NESB reported greater psychological distress, less emotional satisfaction with their partner and more relationship problems in the first 3 months postpartum than Australian born women. Although immigrant mothers had an equivalent level of contact with primary care practitioners in the first 3 months postpartum, they were less likely to be asked about their emotional well-being or about relationship problems by health professionals.     

Oral Health in Women During Preconception and Pregnancy: Implications for Birth Outcomes and Infant Oral Health

The mouth is an obvious portal of entry to the body, and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Maternal periodontal disease, that is, a chronic infection of the gingiva and supporting tooth structures, has been associated with preterm birth, development of preeclampsia, and delivery of a small-for-gestational age infant. Maternal oral flora is transmitted to the newborn infant, and increased cariogenic flora in the mother predisposes the infant to the development of caries. It is intriguing to consider preconception, pregnancy, or intrapartum treatment of oral health conditions as a mechanism to improve women's oral and general health, pregnancy outcomes, and their children's dental health. However, given the relationship between oral health and general health, oral health care should be a goal in its own right for all individuals. Regardless of the potential for improved oral health to improve pregnancy outcomes, public policies that support comprehensive dental services for vulnerable women of childbearing age should be expanded so that their own oral and general health is safeguarded and their children's risk of caries is reduced. Oral health promotion should include education of women and their health care providers ways to prevent oral disease from occurring, and referral for dental services when disease is present.

     

Partner Involvement During Pregnancy and Maternal Health Behaviors

Objectives Healthcare provider focus often rests solely on a pregnant woman, while a woman’s partner may prove to be an ally in a pregnant woman’s health behaviors. The objective of this study is to assess the role of partner support and other demographic factors affecting alcohol and drug use in pregnancy. Methods This cross-sectional cohort study at Thomas Jefferson University Hospital evaluated pregnant women and their partners and obtained sociodemographic information, medical history, tobacco and alcohol use, and results from the Norbeck Social Support Questionnaire (NSSQ). Inclusion criteria were pregnant women 18–44 years old, and English fluency. Subjects without support persons were excluded. Results 198 women were evaluated. Women who reported having a partner were less likely to smoke and drink, as 2.8 % of partnered women smoked and 26 % drank, compared with 12.2 % non-partnered women smoked (p = 0.01), and 42 % drank alcohol (p = 0.07). Significant factors positively influencing the NSSQ included being married, increased household income, and higher education (p < 0.001). On multivariate regression, having a partner and higher income level were the most important predictors of the Social Support Score (p < 0.05). Conclusions for Practice Having a partner during pregnancy is an important factor in alcohol and drug use. Patients with a reliable partner were less likely to smoke cigarettes and drink alcohol in pregnancy. Increased income and relationship status are other important factors for the support of pregnant women.     

Associations Between Preconception Counseling and Maternal Behaviors Before and During Pregnancy

Preconception counseling (PCC) is a vital component of preconception care. Through counseling, providers educate and recommend strategies to improve health and birth outcomes for women of reproductive age. The objective of our analysis was to assess the associations between receipt of PCC and positive maternal behaviors before and during pregnancy. We analyzed 2004?C2008 Pregnancy Risk Assessment Monitoring System data from Maine, New Jersey, Utah, and Vermont. Multivariable logistic regression was used to investigate the associations between receipt of PCC and prepregnancy daily multivitamin consumption, first-trimester entry into prenatal care, and cessation of smoking and drinking before pregnancy among women who smoked/drank in the 2?years preceding the survey, adjusting for a wide range of maternal characteristics. Overall, 32% of women reported receipt of PCC, with particularly low rates reported among women with an unintended pregnancy (14%) and no health insurance prior to pregnancy (14%). Receipt of PCC was associated with daily prepregnancy multivitamin consumption (adjusted odds ratio [AOR]?=?4.4; 95% confidence interval [CI]?=?4.0, 4.7), first-trimester entry into prenatal care for women with an intended pregnancy (AOR?=?2.1; 95% CI?=?1.8, 2.4), and drinking cessation before pregnancy among women who drank in the 2?years preceding the survey (AOR?=?1.3; 95% CI?=?1.2, 1.5). PCC was associated with positive maternal behaviors that increase the likelihood of a healthy woman, pregnancy, and infant. Unfortunately, less than one-third of women with a recent live birth reported receiving PCC. These data provide population-based evidence suggesting the value of PCC in the promotion of healthy maternal behaviors for women with intended or unintended pregnancies.     

Maternal Iron Status in Pregnancy and Child Health Outcomes after Birth: A Systematic Review and Meta-Analysis

In pregnancy, iron deficiency and iron overload increase the risk for adverse pregnancy outcomes, but the effects of maternal iron status on long-term child health are poorly understood. The aim of the study was to systematically review and analyze the literature on maternal iron status in pregnancy and long-term outcomes in the offspring after birth. We report a systematic review on maternal iron status during pregnancy in relation to child health outcomes after birth, from database inception until 21 January 2021, with methodological quality rating (Newcastle-Ottawa tool) and random-effect meta-analysis. (PROSPERO, CRD42020162202). The search identified 8139 studies, of which 44 were included, describing 12,7849 mother–child pairs. Heterogeneity amongst the studies was strong. Methodological quality was predominantly moderate to high. Iron status was measured usually late in pregnancy. The majority of studies compared categories based on maternal ferritin, however, definitions of iron deficiency differed across studies. The follow-up period was predominantly limited to infancy. Fifteen studies reported outcomes on child iron status or hemoglobin, 20 on neurodevelopmental outcomes, and the remainder on a variety of other outcomes. In half of the studies, low maternal iron status or iron deficiency was associated with adverse outcomes in children. Meta-analyses showed an association of maternal ferritin with child soluble transferrin receptor concentrations, though child ferritin, transferrin saturation, or hemoglobin values showed no consistent association. Studies on maternal iron status above normal, or iron excess, suggest deleterious effects on infant growth, cognition, and childhood Type 1 diabetes. Maternal iron status in pregnancy was not consistently associated with child iron status after birth. The very heterogeneous set of studies suggests detrimental effects of iron deficiency, and possibly also of overload, on other outcomes including child neurodevelopment. Studies are needed to determine clinically meaningful definitions of iron deficiency and overload in pregnancy.     

孕期个体化营养指导对妊娠结局及新生儿出生体质量的影响

目的 探讨孕期个体化营养指导对妊娠结局及新生儿出生体质量的影响.方法 选择2011年6月至2012年6月于甘肃省妇幼保健院产科建卡、定期产检且住院分娩的300例单胎孕妇为研究对象,按照建卡时是否接受孕期个体化营养指导,将其分为研究组（n=150,孕期接受个体化营养指导）和对照组（n=150,孕期未接受个体化营养指导）.两组孕妇的年龄、孕前体质量、身高及孕前体质量指数（BMI）等一般临床资料比较,差异无统计学意义（P〉0.05）.比较分析两组孕妇的分娩方式、会阴侧切率、孕前BMI正常孕妇孕期体质量增长及新生儿出生体质量等（本研究遵循的程序符合甘肃省妇幼保健院伦理委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象的知情同意,并与之签署临床研究知情同意书）.结果 研究组与对照组的分娩方式、孕前BMI正常孕妇孕期体质量增长、新生儿出生体质量比较,差异均有统计学意义（χ2=6.72,7.19,16.16,P〈0.05）.研究组与对照组的会阴侧切率比较（26.79% vs.29.67%）,差异无统计学意义（χ2=0.21,P〉0.05）.结论 孕期进行个体化营养指导有利于降低剖宫产率,控制孕期体质量增长及新生儿出生体质量于正常范围.     

孕产期健康教育对母婴健康的影响

目的 通过对孕产期健康教育的对照研究，了解健康教育对母婴健康状况的影响，达到提高母婴健康的目的。方法 随机选取孕产妇293例实施系统的健康教育作为实验组，同期住院而未进行健康教育的127例孕产妇作对照组。就健康状况及妊娠结局等方面进行效果评价。结果 实验组高危妊娠发病率为24．23％，低于对照组的35．43％，差异有统计学意义（Х^2=5．56，p〈0．05）；实验组妊娠晚期贫血的发生率为24．91％，明显低于对照组的38．58％，差异有统计学意义（Х^2=8．03，p〈0．01）；实验组顺产率为52．56％，明显高于对照组的30．71％，实验组剖宫产率为47．44％，明显低于对照组的69．29％，两组比较差异有统计学意义（Х^2=17．03，p〈0．01）；实验组纯母乳喂养率为89．80％，明显高于对照组的59．47％，差异有统计学意义（Х^2=53．16，p〈0．01）。结论孕产期健康教育对提高孕产妇自我保健意识和能力，保障母婴健康等方面有重要意义。     

孕产期健康教育对母婴健康的影响

目的通过对孕产期健康教育的对照研究,了解健康教育对母婴健康状况的影响,达到提高母婴健康的目的。方法随机选取孕产妇293例实施系统的健康教育作为实验组,同期住院而未进行健康教育的127例孕产妇作对照组。就健康状况及妊娠结局等方面进行效果评价。结果实验组高危妊娠发病率为24.23%,低于对照组的35.43%,差异有统计学意义(χ2=5.56,p<0.05);实验组妊娠晚期贫血的发生率为24.91%,明显低于对照组的38.58%,差异有统计学意义(χ2=8.03,p<0.01);实验组顺产率为52.56%,明显高于对照组的30.71%,实验组剖宫产率为47.44%,明显低于对照组的69.29%,两组比较差异有统计学意义(χ2=17.03,p<0.01);实验组纯母乳喂养率为89.80%,明显高于对照组的59.47%,差异有统计学意义(χ2=53.16,p<0.01)。结论孕产期健康教育对提高孕产妇自我保健意识和能力,保障母婴健康等方面有重要意义。     

98例早产低体重儿母体牙周健康状况的调查分析

目的初步了解早产低体重儿母亲在妊娠期间牙周健康状况．为进一步探讨我国早产低体重儿和母体牙周状况的关系打下基础。方法采用问卷调查方法，对98例早产低体重儿母亲进行孕期牙周健康状况预调查．并与103例正常足月儿母亲进行比较。结果早产低体重儿母亲孕期出现牙周病症状的比率高于对照组，差异具有显著性（X^2=27．27，P〈0．005）；在有症状的人群中，早产组的治疗率仅占11．11％，与对照组（占24．19％）比较有显著性差异（P〈0．005）：其中认为牙周病症状是孕期正常现象及经济条件是所有被调查者最主要的没有就诊的原因。结论早产低体重儿母体牙周健康状况可能较差．从而为进一步探讨我国早产低体重儿和母体牙周状况的关系提供依据；同时，需重视妊娠妇女和育龄妇女牙周的健康问题．尽可能减少妊娠不良结局的发生。     

The Effects of Intimate Partner Violence Before, During, and After Pregnancy in Nurse Visited First Time Mothers

To determine the prevalence of intimate partner violence (IPV) before, during and after pregnancy in a national sample of women enrolled in the Nurse Family Partnership (NFP); and, to determine correlates of IPV exposure. Clients enrolled in the NFP between 2002 and 2005 were selected. Data were extracted from NFP client encounter forms including demographic, health habits, family and relationships, and maternal and infant health information. IPV was measured by self-report and assessed during three time periods: 12 months prior to enrollment into the NFP program; during pregnancy up to 36 weeks; and, 12 months since the infant’s birth. Multiple imputation methods were used to account for missing data; univariate, and multivariate analyses were conducted to determine characteristics of IPV exposure over time. IPV in the 12 months prior to pregnancy and at NFP enrollment was 8.1% (95% CI: 5.8–11.2%); 4.7% (4.3.0–5.1%) of women reported IPV during the first 36 weeks of their pregnancy; and, 12.4% (8.5–17.6%) of women reported IPV in the 12 months following delivery. Several IPV correlates were noted, including relationship status (having a partner before and after pregnancy, p < 0.001, p = 0.023, respectively), and maternal health and habits such as smoking (before, during and after pregnancy, p < 0.001, p < 0.001, p = 0.001, respectively). In longitudinal follow-up, reduced use of contraception following the birth of her infant, and rapid repeat pregnancy were significantly associated with IPV exposure. For NFP visited mothers, IPV prevalence is lowest during pregnancy, compared to periods before and after pregnancy. IPV had no demonstrable effect on perinatal outcomes such as gestational age, and birth weight; however, IPV was associated with lower rates of contraceptive use and higher rates of rapid repeat pregnancy in longitudinal follow-up.     

Timing of Incarceration During Pregnancy and Birth Outcomes: Exploring Racial Differences

Objectives To examine whether there are racial differences in the relation between the timing of incarceration during pregnancy and birth outcomes among incarcerated pregnant women. Methods We examined the medical records associated with 360 infants born to pregnant inmates in Texas state prisons between January 1, 2002 and December 31, 2004. Weighted linear regression was used, within racial strata, to model gestational age at delivery, and infant birth weight, respectively, as functions of gestational age at maternal admission to prison. Models were adjusted for maternal age; gravidity; educational attainment; history of tobacco, substance, and alcohol use and the presence of any maternal chronic disease. Results Among Whites there was a 360.8 g lower mean birth weight for infants born to women incarcerated during weeks 14–20 relative to infants born to women incarcerated during weeks 1–13 (p < 0.10). Among Blacks and Hispanics, incarceration after the first trimester was not associated with a significant decrease in infant birth weight relative to incarceration during the first trimester. White women entering prison during the first trimester delivered infants at higher gestational ages than White women entering in the second trimester but the opposite was the case for Hispanics. Conclusions The association between the quantity of exposure to prison during pregnancy and birth outcomes appears to be different for Blacks, Whites, and Hispanic women. Future studies of the effect of incarceration on pregnancy outcomes should attempt to uncover potential racial differences in trends by obtaining racially stratified results or by assessing interaction with race.     

Maternal Employment During Pregnancy and Birth Outcomes: Evidence From Danish Siblings

I use Danish survey and administrative data to examine the impact of maternal employment during pregnancy on birth outcomes. As healthier mothers are more likely to work and health shocks to mothers may impact employment and birth outcomes, I combine two strategies: First, I control extensively for time‐varying factors that may correlate with employment and birth outcomes, such as pre‐pregnancy family income and maternal occupation, pregnancy‐related health shocks, maternal sick listing, and health behaviors (smoking and alcohol consumption). Second, to account for remaining time‐invariant heterogeneity between mothers, I compare outcomes of mothers’ consecutive children. Mothers who work during the first pregnancy trimester have a lower risk of preterm birth. I find no effect on the probability of having a baby of small size for gestational age. To rule out that health selection of mothers between pregnancies drives the results, I focus on mothers whose change in employment status is likely not to be driven by underlying health (mothers who are students in one of their pregnancies and mothers with closely spaced births). Given generous welfare benefits and strict workplace regulations in Denmark, my findings support a residual explanation, namely, that exclusion from employment may stress mothers in countries with high‐female employment rates. Copyright © 2014 John Wiley & Sons, Ltd.     

Depression During Pregnancy and Adverse Birth Outcomes Among Predominantly Puerto Rican Women

Maternal and Child Health Journal - Objectives To examine associations between depression and preterm birth and small-for gestational age (SGA) among women of predominantly Puerto Rican descent, a...     

Association Between Pregnancy Intention and Reproductive-health Related Behaviors Before and After Pregnancy Recognition, National Birth Defects Prevention Study, 1997–2002

Objectives Given that approximately half of all pregnancies in the United States are unplanned, the authors sought to understand the relation between pregnancy intention and health behaviors. Methods Mothers of live-born infants without major birth defects were interviewed as part of the National Birth Defects Prevention Study. The interview assessed pregnancy intention as well as exposures to vitamins, alcohol, tobacco, illicit drugs, occupational hazards, exogenous heat (e.g., hot tubs and saunas) and caffeine. Crude odds ratios and 95% confidence intervals were calculated and stratified analyses were performed to assess interaction. Multiple logistic regression was used to calculate adjusted odds ratios. Results Both before and after the diagnosis of pregnancy, women with unintended pregnancies were more likely to use illicit drugs, smoke, be exposed to environmental smoke, and not take folic acid or multivitamins. The degree to which women altered behaviors after they realized they were pregnant was also associated with their pregnancy intention status. For certain behaviors, maternal age or parity altered the association between pregnancy intention and changing behaviors after awareness of pregnancy. Conclusion Pregnancy intention status is a key determinant of pregnancy-related behavior. To improve reproductive outcomes, preconceptional and prenatal programs should consider a woman’s desire for pregnancy.