The Association between Maternal Oral Health Experiences and Risk of Preterm Birth in 10 States, Pregnancy Risk Assessment Monitoring System, 2004–2006

The aim of this study is to investigate the association between oral health experiences of women in the peripartum period and the risk of preterm delivery (<37?weeks). We analyzed 2004?C2006 data from the CDC Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based surveillance system that collects data on pregnancy and postpartum experiences of mothers who have recently delivered a live infant. Ten states included in the analysis had a ??70% weighted response rate and three standard questions pertaining to oral health. White non-Hispanic (WNH), Black non-Hispanic (BNH), and Hispanic women were selected for analysis. Chi-squared analysis was performed for our bivariate analysis and multivariate logistic regression models were created to calculate adjusted odds ratios, controlling for socio-demographic characteristics and peripartum morbidities. Weighted percentages and standard errors were used for all analyses. Among the 35,267 women studied, in the multivariate analysis, mothers who did not receive dental care during pregnancy and did not have a teeth cleaning during pregnancy were at higher risk for delivering a preterm infant (OR 1.15, CI 1.02?C1.30; OR 1.23, CI 1.08?C1.41). In this population-based study, women who did not receive dental care or have a teeth cleaning during pregnancy were at slightly higher risk for preterm delivery after adjustment for pertinent confounders.     

Comparing Postpartum Care Utilization from Medicaid Claims and the Pregnancy Risk Assessment Monitoring System in Wisconsin, 2011–2015

Maternal and Child Health Journal - To compare two data sources from Wisconsin—Medicaid claims and Pregnancy Risk Assessment Monitoring System (PRAMS) surveys—for measuring postpartum...     

Trends in Prenatal Discussion and HIV Testing, 1996–2001: Pregnancy Risk Assessment Monitoring System

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.     

Assessment of Heavy Metal Contents in Surface Soil in the Lhasa–Shigatse–Nam Co Area of the Tibetan Plateau,China

Eight important heavy metals (As, Cr, Cu, Ni, Pb, Zn, Mn, and Hg) were investigated in surface soil samples collected from the Lhasa–Shigatse–Nam Co region, Tibetan Plateau, China. The mean contents of As, Cr, Cu, Ni, Pb, Zn, Mn, and Hg in the samples were 39.5, 57.4, 28.5, 48.2, 15.7, 79.2, 637 and 0.0175 mg/kg, respectively. All metals were divided into three clusters by cluster analysis. The results of geoaccumulation index indicated that no samples were polluted by Cr, Pb, Zn, and Mn, and samples were polluted with As, Cu, Ni, and Hg to different degrees. All surface soils had a low ecological risk with potential ecological risk index below 150, indicating a low ecological risk. As, Pb, and Hg were the primary contributors to potential ecological risk.     

Pregnancy Intendedness and Physical Abuse Around the Time of Pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System, 1996–1997

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     

Association Between Maternal Multivitamin Use and Preterm Birth in 24 States,Pregnancy Risk Assessment Monitoring System, 2009–2010

Objectives The study objective was to examine the prevalence of maternal multivitamin use and associations with preterm birth (<37 weeks gestation) in the United States. We additionally examined whether associations differed by race/ethnicity. Methods Using the Pregnancy Risk Assessment Monitoring System, we analyzed 2009–2010 data among women aged ≥18 years with a singleton live birth who completed questions on multivitamin use 1 month prior to pregnancy (24 states; n = 57,348) or in the last 3 months of pregnancy (3 states, n = 5095). Results In the month prior to pregnancy, multivitamin use ≥4 times/week continued to remain low (36.8 %). In the last 3 months of pregnancy, 79.6 % of women reported using multivitamins ≥4 times/week. Adjusting for confounders, multivitamin use 1–3 times/week or ≥4 times/week prior to pregnancy was not associated with preterm birth overall. Though there was no evidence of dose response, any multivitamin use in the last 3 months of pregnancy was associated with a significant reduction in preterm birth among non-Hispanic black women. Conclusions for Practice Multivitamin use during pregnancy may help reduce preterm birth, particularly among populations with the highest burden, though further investigations are warranted.     

Assessment of Sexual Behavior,Sexual Attitudes,and Sexual Risk in Sweden (1989–2003)

To assess changes in sexual behavior, sexual attitudes, and sexual risk related to HIV, we conducted mailed questionnaire surveys in random samples of the Swedish general population in 1989, 1994, 1997, 2000, and 2003 (total N = 13,762). Each sample consisted of 4,000–6,000 subjects aged 16–44 years, stratified by age: 16–17, 18–19, 20–24, 25–34, and 35–44 years. The overall participation rate was 63.8% (for men, 55.9%; for women, 71.9%). The prevalence of three or more sexual partners and casual sexual contacts without the use of a condom was comparatively high for men, for persons aged 16–24 years, single persons with and without a regular partner, and persons living in towns and urban areas. The prevalence of multiple sexual partners and casual sexual contacts increased significantly over time. There was a significant decrease in the proportion of participants who agreed with the statement Sexual intercourse should only take place in a stable relationship. Personal risk assessments related to HIV did not change significantly over time. The study shows that risky sexual behavior related to HIV/AIDS increased in the Swedish population between 1989 and 2003, and that attitudes concerning casual sexual relations became more permissive.     

The Content of Cobalt,Silver and Vanadium in Raw Cow’s Milk in Croatia and Risk Assessment for Consumers

Concentrations of selected trace elements Ag, Co and V in raw milk sampled from four geographical regions in Croatia were measured. Silver, Co and V were detected above the limit of detection within the range of 9.52%–30.8%, 1.6%–12.1% and 12.4%–30.8%. Silver concentrations were not detected in milk samples from the Croatian Littoral and Mountainous Croatia (CL-MC) region. Similar Ag content was found in Southern, Eastern and Central Croatia. The lowest mean of Co and V of 33.2 and 83.8 µg kg^?1 were found in the CL-MC region while the highest of 49.8 and 136.9 µg kg^?1 was found in Central Croatia. There were no statistically significant differences in Ag, Co and V contents between the four regions. The estimated daily dietary intakes (EDI) of total mean and total 95th percentile values of Ag, Co and V showed lower values in comparison with available EFSA health-based limits.

     

The Racial/Ethnic Distribution of Heat Risk–Related Land Cover in Relation to Residential Segregation

Objective: We examined the distribution of heat risk–related land cover (HRRLC) characteristics across racial/ethnic groups and degrees of residential segregation.Methods: Block group–level tree canopy and impervious surface estimates were derived from the 2001 National Land Cover Dataset for densely populated urban areas of the United States and Puerto Rico, and linked to demographic characteristics from the 2000 Census. Racial/ethnic groups in a given block group were considered to live in HRRLC if at least half their population experienced the absence of tree canopy and at least half of the ground was covered by impervious surface (roofs, driveways, sidewalks, roads). Residential segregation was characterized for metropolitan areas in the United States and Puerto Rico using the multigroup dissimilarity index.Results: After adjustment for ecoregion and precipitation, holding segregation level constant, non-Hispanic blacks were 52% more likely (95% CI: 37%, 69%), non-Hispanic Asians 32% more likely (95% CI: 18%, 47%), and Hispanics 21% more likely (95% CI: 8%, 35%) to live in HRRLC conditions compared with non-Hispanic whites. Within each racial/ethnic group, HRRLC conditions increased with increasing degrees of metropolitan area-level segregation. Further adjustment for home ownership and poverty did not substantially alter these results, but adjustment for population density and metropolitan area population attenuated the segregation effects, suggesting a mediating or confounding role.Conclusions: Land cover was associated with segregation within each racial/ethnic group, which may be explained partly by the concentration of racial/ethnic minorities into densely populated neighborhoods within larger, more segregated cities. In anticipation of greater frequency and duration of extreme heat events, climate change adaptation strategies, such as planting trees in urban areas, should explicitly incorporate an environmental justice framework that addresses racial/ethnic disparities in HRRLC.     

The Accumulation and Distribution of Metals in Water, Sediment, Aquatic Macrophytes and Fishes of the Gruža Reservoir, Serbia

The concentrations of iron, lead, cadmium, copper, manganese, mercury and arsenic were measured in water, sediment, five macrophytes (Typha angustifolia, Iris pseudacorus, Polygonum amphybium, Myriophyllum spicatum and Lemna gibba) and five fish species (Sander lucioperca, Abramis brama, Carassius gibelio, Silurus glanis and Arystichtys nobilis) in the Gru?a Reservoir, used for water supply and recreational fishing. The concentrations of all examined elements were higher in sediment than in water. The values of the ratio between element concentrations in the sediment and those in the water were the highest for Fe and As. Among the five plant species, the highest concentrations of Pb and Mn were observed in T. angustifolia, while the highest concentrations of Fe, Cu and Hg were in L. gibba. I. pseudacorus and P. amphybium had the highest concentrations of Cd and As, respectively. Among the fish species, C. gibelio showed the highest tendency of element accumulation (Fe, Cd, Cu), followed by S. lucioperca (Pb, Hg), A. brama (Mn) and A. nobilis (As). The average concentrations of elements in fish muscle, except for As in A. nobilis (2.635 ± 0.241 mg kg^?1 ww), were below the limits that are considered safe for human consumption in accordance with the European Commission Regulation and Official Gazette of Serbia.     

Postpartum Mental Health and Breastfeeding Practices: An Analysis Using the 2010–2011 Pregnancy Risk Assessment Monitoring System

Maternal and Child Health Journal - Objective Evidence suggests that women with postpartum depression (PPD) are at risk for early breastfeeding cessation, but previous studies have been limited by...     

Assessment of DDT and Metabolites in Soil and Sediment of Potentially Contaminated Areas of Belém,Amazon Region,Brazil

The aim of this study was to evaluate the distribution of DDT and metabolites in surface soils and soil profiles from two areas containing deposits of obsolete pesticides in Belém, Amazon Region, Brazil. DDT and metabolites were extracted by microwave assisted extraction and analyzed by gas chromatography with electron capture detection. Concentrations of total DDT in surface soil samples ranged from 64.22 mg?kg^?1 in area 1 (A1) to 447.84 mg?kg^?1 in area 2 (A2). Lower levels were found in soil profiles than at the surface (6.21–21.17 mg?kg^?1 in A1 and 36.13–113.66 mg?kg^?1 in A2). pp’-DDT, pp′-DDE and pp′-DDD were detected in sediments at levels of 2.01, 0.96 and 0.35 mg?kg^?1, respectively. The ratio (DDE?+?DDD)/ΣDDT was low indicating the recent introduction of DDT to the environment in the two study areas, through the volatilization and atmospheric deposition of the obsolete pesticides.     

Adolescent Pregnancy and Smoking in West Virginia: Pregnancy Risk Assessment Monitoring System (PRAMS) 2005–2010

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.     

System for Rapid Assessment of Pneumonia and Influenza-Related Mortality—Ohio, 2009–2010

Rapid mortality surveillance is critical for state emergency preparedness. To enhance timeliness during the 2009–2010 influenza A H1N1 pandemic, the Ohio Department of Health activated a drop-down menu within Ohio’s Electronic Death Registration System for reporting of pneumonia- or influenza-related deaths approximately 5 days postmortem. We used International Classification of Diseases—Tenth Revision (ICD-10) codes, available 2–3 months postmortem as the standard, and assessed their agreement with drop-down-menu codes for pneumonia- or influenza-related deaths. Among 56 660 Ohio deaths during September 2009–March 2010, agreement was 97.9% for pneumonia (κ = 0.85) and 99.9% for influenza (κ = 0.79). Sensitivity was 80.2% for pneumonia and 73.9% for influenza. Drop-down menu coding enhanced timeliness while maintaining high agreement with ICD-10 codes.     

The Association Between Preconception Care Receipt and the Timeliness and Adequacy of Prenatal Care: An Examination of Multistate Data from Pregnancy Risk Assessment Monitoring System (PRAMS) 2009–2011

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.