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1.
Objectives We partnered with a Massachusetts family workgroup to analyze state level data that would be most useful to consumers and
advocates in Massachusetts. Methods Massachusetts’ and US data from the 2001 National Survey of Children with Special Health Care Needs (NSCSHCN) were analyzed.
We examined types of need and prevalence of unmet need for all CSHCN and for more severely affected CSHCN. We also correlated
unmet need to child and family characteristics using multivariate logistic regression. Results In Massachusetts, 17% of CSHCN and 37% of children more severely affected did not receive needed care. CSHCN who were uninsured
anytime during the previous year were nearly 5 times more likely to experience an unmet need (OR = 4.95, CI: 1.69–14.51).
Children with more functional limitations (OR = 3.15; CI: 1.59–6.24) and unstable health care needs (OR = 3.26; CI: 1.33–8.00)
were also more likely to experience an unmet need. Receiving coordinated care in a medical home (OR = 0.46; CI: 0.23–0.90)
was associated with reduced reports of unmet need. Conclusions With input from families of CSHCN, researchers can direct their analyses to answering the questions and concerns most meaningful
to families. We estimate that 1 in 6 CSHCN in Massachusetts did not receive needed care, with more than 1 in 3 CSHCN with
a more severe condition experiencing an unmet need. Enabling factors were predictors of unmet need suggesting solutions such
as expanding insurance coverage and improving services systems for CSHCN. 相似文献
2.
Stevens GD West-Wright CN Tsai KY 《Journal of immigrant and minority health / Center for Minority Public Health》2010,12(3):273-281
Objectives To examine differences and trends in health insurance coverage and access to care for California families by immigration
status. Methods Cross-sectional data on 37,236 families with young children <18 years of age from the 2001, 2003 and 2005 California Health
Interview Survey are used to assess trends in health insurance and access to care for children and their parents by four immigration
dyads: (1) both are Citizens; (2) child is a legal resident/citizen, and parent is legal resident (Documented); (3) child
is a citizen, and parent is undocumented (Mixed); and (4) both are Undocumented. Results Before and after adjustment for covariates, only children in Undocumented dyads were less likely than Citizen dyads to have
insurance (OR = 0.20, CI: 0.16–0.26) and all three measures of access: physician visits (OR = 0.69, CI: 0.52–0.91), dental visits (OR = 0.47, CI: 0.35–0.63), and a regular
source of care (OR = 0.51, CI: 0.37–0.69). Parents in all non-Citizen dyads had poorer access than Citizen dyads across all
measures, with the exception of dental visits and a regular source for parents in Documented dyads. Children of all dyads
except Citizens were more likely to be insured in 2005 vs. 2001. The largest gain was for undocumented dyad children with
2.77 times higher odds (CI: 1.62–4.75) of being insured in 2005 vs. 2001. All children dyads except Mixed were also more likely
to have a physician visit. For parents, there was only a decrease in insurance coverage for Citizen dyads (OR = 0.79, CI:
0.67–0.93) and few changes in access. Conclusions While there were relatively few disparities and some improvements in insurance coverage and access for children in California
(except for undocumented children), concomitant changes for parents were not observed. Without attention to the family in
health care reforms, disparities may not fully resolve for children and may continue or even increase for parents. 相似文献
3.
Objectives To identify prenatal and perinatal factors that predict women at risk of sub-clinical and major postpartum depression among
a cohort of low medical risk pregnant women in Canada. Methods Data from 1,403 women who completed a randomized controlled trial of supplementary support during pregnancy was analyzed
to identify risk factors for sub-clinical and major postpartum depression. The Edinburgh Postnatal Depression Scale (EPDS),
completed at eight weeks postpartum, was used to classify each woman’s depression symptom severity. Demographic, obstetric,
behavioral risk, mental health and psychosocial factors were considered. Multiple logistic regression analyses were used to
identify risk factors most predictive of sub-clinical and major postpartum depression. Results After adjustment for other covariates, variables that increased the risk of sub-clinical postpartum depression included a
history of depression (OR = 2.27, CI = 1.42–3.63), anxiety symptoms during pregnancy (OR = 2.12, CI = 1.09–4.11), being born
outside Canada (OR = 1.87, CI = 1.17–3.00), and low parenting self-efficacy (OR = 1.65, CI = 1.06–2.55). Variables that increased
the risk of major postpartum depression included a history of depression (OR = 2.78, CI = 1.56–4.97), being born outside Canada
(OR = 2.97, CI = 1.70–5.17), depressive symptoms during pregnancy (OR = 2.83, CI = 1.29–6.19) and not breastfeeding at eight
weeks postpartum (OR = 2.12, CI = 1.21–3.70). Conclusions A history of depression and being born outside Canada predicted women who were at an increased risk of sub-clinical and major
postpartum depression. The remaining risk factors specific to sub-clinical and major postpartum depression suggest some differences
between women vulnerable to sub-clinical compared to major depressive symptoms in the postpartum period, which may have implications
for targeted screening and intervention strategies. 相似文献
4.
Schneiderman JU Leslie LK Hurlburt MS Zhang J Horwitz SM 《Maternal and child health journal》2012,16(2):328-335
The study objectives were to examine serious injuries requiring medical attention among children who remain at home after
a child welfare/child protective services (CPS) maltreatment investigation in the US and to determine whether child/caregiver
characteristics and ongoing CPS involvement are related to injuries requiring medical attention. Using the National Survey
of Child and Adolescent Well-being, we analyzed data on the subsample of children who remained at home (N = 3,440). A multivariate
logistic regression model included child characteristics, chronic illness and disability in the child, level of CPS involvement,
subsequent foster care placement, caregiver characteristics, and caregiver/family psychological variables. Injuries requiring
medical attention were identified in 10.6% of the in-home population over a15-month period, with no differences in rates by
age. Children with a chronic medical condition (OR = 2.07; 95% CI, 1.20–3.58) and children with depressed caregivers (OR = 2.28;
95% CI, 1.45–3.58) were more likely to have an injury that required medical care. Older caregivers (>54 years) were less likely
(OR = 0.15; 95% CI, 0.03–0.69) to have a child with an injury requiring care. Injuries were not related to further involvement
with CPS after the initial maltreatment investigation. Children with chronic medical conditions who remained in their biological
homes or whose caregivers were depressed were likely to experience an injury requiring medical attention. Older caregivers
were less likely to report a child injury. Extending existing health policies for foster children to children who remain at
home following referral to CPS may encourage more comprehensive injury prevention for this population. 相似文献
5.
Bodenmann P Cornuz J Vaucher P Ghali W Daeppen JB Favrat B 《Journal of immigrant and minority health / Center for Minority Public Health》2010,12(1):24-32
Background Little is known about smoking, unhealthy use of alcohol, and risk behaviours for sexually transmitted diseases (STDs) in
immigrants from developed and developing countries. Method We performed a cross-sectional study of 400 patients who consulted an academic emergency care centre at a Swiss university
hospital. The odds ratios for having one or more risk behaviours were adjusted for age, gender, and education level. Results Immigrants from developing countries were less likely to use alcohol in an unhealthy manner (OR = 0.35, 95% CI 0.22–0.57)
or practise risk behaviours for STDs (OR = 0.31, 95% CI 0.13–0.74). They were also less likely to have any of the three studied
risk behaviours (OR = 2.5, 95% CI 1.5–4.3). Discussion In addition to the usual determinants, health behaviours are also associated with origin; distinguishing between immigrants
from developing and developed countries is useful in clinical settings. Surprisingly, patients from developing countries tend
to possess several protective characteristics. 相似文献
6.
Objectives To evaluate whether Massachusetts Early Intervention (EI) serves children at risk of developmental delay due to social factors,
we identified socio-demographic characteristics associated with program enrollment and examined predictors of participation
at each stage from referral to enrollment. Methods The Pregnancy to Early Life Longitudinal (PELL) data system linked birth certificate, hospital discharge, and EI data for
all Massachusetts births, 1998–2000. We identified predictors of enrollment among births and predictors of referral, eligibility
evaluation among those referred, and enrollment among eligible children using multivariate modified Poisson models to adjust
for medical risks. Results Overall, 29,950 children (13.7% of births) enrolled in EI. Most social risk indicators predicted enrollment, including maternal
government insurance (RR = 1.32, 95% CI 1.29–1.36) and maternal education ≤10 years (RR = 1.36, 95% CI 1.30–1.42). Having
a foreign-born (RR = 0.77, 95% CI 0.74–0.80), non-English speaking (RR = 0.93, 95% CI 0.89–0.97) or Asian (RR = 0.88, 95%
CI 0.82–0.94) mother was negatively associated with enrollment. Of births, 18.6% were referred to EI. Similar socio-demographic
variables predicted referral as predicted enrollment. Among referrals, 87.7% received an evaluation. Evaluation was negatively
associated with young maternal age, black maternal race, and high poverty level. Of eligible children, 93.0% enrolled. Enrollment
among eligible children was negatively associated with young maternal age and high poverty level. Conclusion In Massachusetts, children born with social risk factors have high EI participation. Nevertheless, children in immigrant
communities may face barriers to initial contact with EI, while children from low socioeconomic environments may be at risk
for not enrolling after EI referral.
相似文献
Milton KotelchuckEmail: |
7.
8.
Pracha P. Eamranond Roger B. Davis Russell S. Phillips Christina C. Wee 《Journal of immigrant and minority health / Center for Minority Public Health》2009,11(6):494-498
Objective Patient-physician language discordance is associated with worse quality of healthcare for patients with limited English proficiency.
Patients with language-discordant physicians have more problems understanding medical situations. The impact of patient-physician
language concordance on lifestyle counseling among Spanish-speaking patients is not known. Methods We performed a retrospective medical record review and identified 306 Spanish-speaking patients who used interpreter services
between June 2001 and June 2006 in two Boston-based primary care practices. Our primary outcome was counseling on exercise,
diet, and smoking. Our main predictor of interest was patient-physician language concordance. Results Patients with language-concordant physicians were more likely to be counseled on diet and physical activity compared to patients
with language-discordant physicians. After adjustment for age, sex, insurance status, number of primary care visits, and comorbidity
score, these differences in counseling persisted for diet [odds ratio (OR) = 2.2, CI 1.3–3.7] and physical activity (OR = 2.3,
CI 1.4–3.8). There was no significant difference with regard to discussion of smoking (OR = 1.3, CI 0.8–2.1). Conclusions Spanish-speaking patients are more likely to discuss diet and exercise modification if they have a Spanish-speaking physician
compared to those having a non-Spanish-speaking physician. Further research is needed to explore whether matching Spanish-speaking
patients with Spanish-speaking providers may improve lifestyle counseling. 相似文献
9.
Steven Allender Kremlin Wickramasinghe Michael Goldacre David Matthews Prasad Katulanda 《Journal of urban health》2011,88(5):906-918
The aim of this study was to investigate the poorly understood relationship between the process of urbanization and noncommunicable
diseases (NCDs) in Sri Lanka using a multicomponent, quantitative measure of urbanicity. NCD prevalence data were taken from
the Sri Lankan Diabetes and Cardiovascular Study, comprising a representative sample of people from seven of the nine provinces
in Sri Lanka (n = 4,485/5,000; response rate = 89.7%). We constructed a measure of the urban environment for seven areas using a 7-item scale
based on data from study clusters to develop an “urbanicity” scale. The items were population size, population density, and
access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and
housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and
chronic disease risk factors. Among men, urbanicity was positively associated with physical inactivity (odds ratio [OR] = 3.22;
2.27–4.57), high body mass index (OR = 2.45; 95% CI, 1.88–3.20) and diabetes mellitus (OR = 2.44; 95% CI, 1.66–3.57). Among
women, too, urbanicity was positively associated with physical inactivity (OR = 2.29; 95% CI, 1.64–3.21), high body mass index
(OR = 2.92; 95% CI, 2.41–3.55), and diabetes mellitus (OR = 2.10; 95% CI, 1.58 – 2.80). There is a clear relationship between
urbanicity and common modifiable risk factors for chronic disease in a representative sample of Sri Lankan adults. 相似文献
10.
Dutta A Gervey R Chan F Chou CC Ditchman N 《Journal of occupational rehabilitation》2008,18(4):326-334
Introduction This study examined the effect of vocational rehabilitation services on employment outcomes of people with sensory/communicative,
physical, and mental impairments in the United States. Methods The sample frame includes 5,000 clients for each of the three disability groups whose cases were closed as either rehabilitated
or not rehabilitated by state vocational rehabilitation agencies in the fiscal year 2005. The dependent variable is employment
outcome. The predictor variables include a set of personal history variables and vocational rehabilitation service variables.
Results Sixty-two percent of the clients in this study were gainfully employed after receiving vocational rehabilitation services.
Individuals with sensory/communicative impairments had the highest success rate (75%) compared to 56% for the physical impairments
group and 55% for those with mental impairments. Logistic regression analyses identified job placement, on-the-job support,
maintenance, and other services (e.g., medical care for acute conditions) as significant predictors of employment success
across all impairment groups. In addition, diagnostic and treatment (D&T) services (odds ratio [OR] = 1.57; 95% CI: 1.35–1.82)
and rehabilitation technology services (OR = 1.97, 95% CI: 1.67–2.33) were found to uniquely contribute to employment outcomes
for the sensory impairments group as well as the physical impairments group (D&T services: OR = 1.31, 95% CI: 1.15–1.48; RT
services: OR = 1.41, 95% CI: 1.13–1.75), but not the mental impairments group. Substantial counseling was associated with
employment outcomes for the physical (OR = 1.16, 95% CI: 1.02–1.32) and mental impairments groups (OR = 1.18, 95% CI: 1.03–1.35).
Miscellaneous training (OR = 1.31; 95% CI: 1.09–1.49) was specifically associated with employment outcomes of the mental impairments
group. Conclusion This study provides some empirical support documenting the association between vocational rehabilitation services and employment
outcomes of people with disabilities. 相似文献
11.
Peterson L Soliman A Ruterbusch JJ Smith N Schwartz K 《Journal of immigrant and minority health / Center for Minority Public Health》2011,13(6):1033-1040
Arab American (ArA) women may be at greater risk for thyroid cancer (TC) than White women. This case-case comparison explored
differences in known and proposed risk factors of TC among ArA and non-Hispanic White (NHW) female TC cases in metropolitan
Detroit. Cases of invasive TC identified from a population-based registry responded to a telephone survey regarding potential
TC risk factors. Thirty ArA women (response rate 52%) and 70 NHW women (67%) participated. NHW women reported significantly
more prior thyroid disease (TD), family history of TD, hormone use, cumulative years of hormone use, cigarette and alcohol
consumption. In adjusted logistic regression analysis, ArA women had significantly higher odds of exposure to dental x-rays
(OR = 3.48, CI 1.01–12.00) and medical radiation (OR = 13.58, CI 1.49–124.04) than NHW women. Risk factors for TC may differ
among ArA women and their NHW counterparts. 相似文献
12.
13.
Nülüfer Erbil 《Sexuality and disability》2011,29(4):377-386
Female sexual dysfunction is a common health problem for many women all over the world. This study was constructed to determine
risk factors and prevalence of female sexual dysfunction among Turkish women, in Ordu province of Turkey between May 2008
and December 2008. Four hundred and twenty-five married women, between 18 and 56 years of age, who consented to participate,
were included in the study. Data was collected by using a questionnaire form and the Female Sexual Function Index. The prevalence
of female sexual dysfunction was 52.2%. The risk factors for female sexual dysfunction were, low education level of the woman
(odds ratio [OR] = 1.830, 95% confidence interval [CI] = 1.088–3.078), low education level of the husband (OR = 1.734, 95%
CI = 1.094–2.750), being brought up by parents with restrictive attitudes (OR = 1.558, 95% CI = 1.001–2.424), and having genital
infections or symptoms (OR = 1.925, 95% CI = 1.213–3.055). 相似文献
14.
Wallace LS DeVoe JE Heintzman JD Fryer GE 《Journal of immigrant and minority health / Center for Minority Public Health》2009,11(6):453-459
Background To examine influence of language preference—English versus Spanish—on Hispanics’ perceptions of their healthcare providers’
communication behaviors. Methods Using the 2005 Medical Expenditure Panel Survey (MEPS), we observed non-institutionalized Hispanics (n = 5197; US population estimate = 27,070,906), aged ≥18 years, reporting visiting a healthcare provider within the past 12 months.
Results When compared to Spanish responders (reference group), English responders were more likely to report that their healthcare
provider “always” listened to them carefully (adjusted odds ratio (OR) = 1.39, 95% confidence interval (CI) 1.09–1.78), “always”
explained things so that they understood (adjusted OR 1.37, 95% CI 1.08–1.73), “always” spent enough time with them (adjusted
OR = 1.62, 95% CI 1.24–2.11),”always” asked them to help make decisions (adjusted OR 1.37, 95% CI 1.03–1.82), and “always”
showed respect for treatment decisions (adjusted OR = 1.66, 95% CI 1.27–2.19). Discussion Healthcare providers should consider the complex needs of Hispanic patients whose language of choice is not English. 相似文献
15.
Objective The objective of this study was to examine the relationship between maternal pre-pregnancy obesity and a diagnosis of asthma
in offspring at age 3 years. Methods A population-based sample of children born in large U.S. cities in 1998–2000 was followed since birth (N = 1971). The main
outcome measure was whether the mother reported at 3 years that the child had ever been diagnosed with asthma. Multilevel
logistic regression models were used to estimate the association between maternal pre-pregnancy obesity and child asthma diagnosis,
as well as the extent to which the association can be explained by sociodemographic, medical, obstetric, and behavioral factors
associated with both conditions. Results Children with obese mothers had 52% higher odds of having an asthma diagnosis by age 3 (OR = 1.52; 95% CI: 1.18–1.93). Sociodemographic,
medical, obstetric, and behavioral factors explained some, but not all, of the association. Conclusions Maternal pre-pregnancy obesity is associated with diagnosis of asthma in offspring at age 3 years. The results from this
study are preliminary and need to be replicated and further explored, but are suggestive of a complex intergenerational linkage
between obesity and asthma. 相似文献
16.
The objectives of this study were to (1) measure health insurance coverage and continuity across generational subgroups of
Latino children, and (2) determine if participation in public benefit programs is associated with increased health insurance
coverage and continuity. We analyzed data on 25,388 children income-eligible for public insurance from the 2003 to 2004 National
Survey of Children’s Health and stratified Latinos by generational status. First- and second-generation Latino children were
more likely to be uninsured (58 and 19%, respectively) than third-generation children (9.5%). Second-generation Latino children
were similarly likely to be currently insured by public insurance as third-generation children (61 and 62%, respectively),
but less likely to have private insurance (19 and 29%, respectively). Second-generation Latino children were slightly more
likely than third-generation children to have discontinuous insurance during the year (19 and 15%, respectively). Compared
with children in families where English was the primary home language, children in families where English was not the primary
home language had higher odds of being uninsured versus having continuous insurance coverage (OR: 2.19; 95% CI [1.33–3.62]).
Among second-generation Latino children, participation in the Food Stamp (OR 0.26; 95% CI [0.14–0.48]) or Women, Infants,
and Children (OR 0.40; 95% CI [0.25–0.66]) programs was associated with reduced odds of being uninsured. Insurance disparities
are concentrated among first- and second-generation Latino children. For second-generation Latino children, connection to
other public benefit programs may promote enrollment in public insurance. 相似文献
17.
Katherine S. Redding Ellen Funkhouser Isabel C. Garcés-Palacio Sharina D. Person Mirjam C. Kempf Isabel C. Scarinci 《Maternal and child health journal》2010,14(2):274-282
Little is known about vaginal douching among Latina immigrants in the U.S. Understanding factors associated with douching
is important due to the negative reproductive outcomes associated with this practice. This study examined demographic and
behavioral factors associated with vaginal douching among Latina immigrants. A cross-sectional anonymous survey was administered
among a convenience sample of 206 Latina immigrants aged 19–44 years (mean = 28 years) living in the U.S. at least 6 months
(mean = 4 years). Demographic and behavioral characteristics, history of regular douching (at least once a month for 6 months),
and current regular douching (at least once a month for the last 6 months) were assessed. Adjusted odds ratios (adj. OR) were
estimated using multiple logistic regression. Overall, 25% (n = 50) of women reported ever douching regularly and 15% (n = 31) reported current regular douching. Ever douching regularly was significantly associated with a woman’s number of lifetime
sex partners (adj. OR = 1.6 per additional partner over one, 95% CI: 1.1–2.5), hormonal contraceptive use (adj. OR = 0.3,
95% CI: 0.1–0.9), and healthcare seeking behavior (adj. OR = 2.3, 95% CI: 1.1–5.2). Regular vaginal douching is a common practice
among Latina immigrants. Factors associated with douching in this population vary from those in other U.S. populations and,
therefore, it needs to be addressed in a culturally appropriate manner. 相似文献
18.
Tovar A Must A Bermudez OI Hyatt RR Chasan-Taber L 《Maternal and child health journal》2009,13(4):520-530
Objective To examine the association of gestational weight gain and dietary factors with abnormal glucose tolerance (AGT). Methods We conducted a prospective cohort study among 813 Hispanic prenatal care patients in Massachusetts. Gestational weight gain
and oral glucose tolerance test results were abstracted from medical records. Dietary intake was assessed using a semi-quantitative
food frequency questionnaire. Target weight gain was based on BMI-specific weekly weight gain rates established by the Institute
of Medicine (IOM). Results We observed a statistically significant interaction between prepregnancy BMI and weight gain in relation to AGT (P < 0.01). Class II/III (BMI ≥ 35 kg/m2) obese women who had a high rate of weight gain (>0.30 kg/week) or who exceeded target weight were 3–4 times as likely to
develop AGT compared to women who gained within IOM ranges (OR = 4.2, 95% CI 1.1–16.0, OR = 3.2 95% CI 1.0–10.5, respectively).
Increasing levels of saturated fat and fiber and decreasing levels of energy-dense snack foods and polyunsaturated fat:saturated
fat ratio were significantly associated with increased risk of AGT, independent of gestational weight gain. Conclusions Weight gain among class II/III obese women and certain dietary components may represent modifiable risk factors for AGT.
An erratum to this article can be found at 相似文献
19.
Kouichi Yoshimasu Chikako Kiyohara Kazuhisa Miyashita The Stress Research Group of the Japanese Society for Hygiene 《Environmental health and preventive medicine》2008,13(5):243-256
The purpose of the present review is to evaluate the effects of common risk factors for suicide by meta-analyses using data
extracted from studies based on the psychological autopsy method. We focused on five common risk factors of suicide: substance-related
disorders, mood disorders, adverse marital status, adverse employment status, and self-harm behaviors. A total of 24 articles
were identified from MEDLINE in which the crude odds ratio (OR) could be calculated for the above five risk factors through
30 April 2007, using such search keywords as “suicide,” “psychological autopsy,” and “case-control study.” Overall, both substance-related
disorders [OR = 5.24; 95% confidence interval (CI) = 3.30–8.31] and mood disorders [OR = 13.42; 95% CI = 8.05–22.37] were
strongly associated with suicidal risk. Suicidal attempt and deliberate self-harm, which can directly lead to completed suicide,
have been shown to be very strongly associated with suicidal risk [OR = 16.33; 95% CI = 7.51–35.52]. Effects of social factors
such as adverse marital and employment status were relatively small. As substance-related disorders and mood disorders were
strongly associated with an increased risk of completed suicide, the comorbidity of these two disorders should be paid a maximum
attention. The effective prevention of suicide depends on whether we can successfully incorporate these personal factors as
well as social factors into an adequate multi-factorial model.
Members of the Stress Research Group of the Japanese Society for Hygiene are listed in the Appendix. 相似文献
20.
Corina Pogodina Larissa R. Brunner Huber Elizabeth F. Racine Elena Platonova 《Journal of community health》2009,34(5):376-382
There is growing evidence that environmental tobacco smoke (ETS) exposure may negatively affect birth outcomes, especially
birth weight. This study evaluates the effect of residential ETS exposure on the risk of having a low birth weight (LBW) infant
and investigates whether there is a dose–response relationship. This retrospective cohort study comprised 2,206 women who
participated in the 2004–2005 North Carolina Phase V Pregnancy Risk Assessment Monitoring System. Women self-reported information
on ETS exposure and birth weight was obtained from birth certificates. Logistic regression was used to obtain odds ratios
and 95% confidence intervals. When adjusted for marital status and income, women exposed to ETS during pregnancy had increased
odds of delivering a LBW baby (OR = 1.29, 95% CI: 1.06, 1.57). After adjustment for the same covariates, a weak dose–response
relationship between ETS and LBW was found (OR = 1.28, 95% CI: 1.03, 1.60 for women who were exposed to ETS generated by one
cigarette smoker; OR = 1.31, 95% CI: 0.96, 1.31 for those who were exposed to ETS generated by two or more cigarette smokers).
This study provides evidence of the adverse effect of residential ETS on pregnancy outcomes. The observed relationship emphasizes
the health hazard that ETS exposure in the home poses to pregnant women and their unborn babies. Educational anti-tobacco
campaigns and quit smoking initiatives should target both mothers and fathers to ensure smoke-free living conditions and a
healthy environment for all family members. 相似文献