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INFANT MATERNAL AND REPRODUCTIVE HEALTH

Reducing Maternal Depression and Its Impact on Young Children
Project Thrive Issue Brief No. 2
This policy brief provides an overview of why it is so important to address maternal depression as a central part of the effort to ensure that ALL young children enter school ready to succeed. To read the full text, please go to: http://www.nccp.org/publications/pdf/text_791.pdf [PDF; 261 kb]

Postpartum Depression Screening: Important, Methods, Barriers and, commendations for Practice
This review discusses the potential benefit of mass screening for improving postpartum depression recognition and outcomes. To read more, please go to: http://www.jabfm.org/cgi/content/full/20/3/280

PREGNANCY

Article Describes Development and Implementation of Tool to Screen for Psychosocial Risks
"The development and successful implementation of a multi-dimensional prenatal screening tool is one key step towards ultimately determining the relationship between specific risk factors and poor birth outcomes," state the authors of an article published in the February 2008 issue of the Journal of Health Care for the Poor and Underserved.

Harrison PA, Sidebottom AC. 2008. Systematic prenatal screening for psychosocial risks. Journal of Health Care for the Poor and Underserved 19(1):258-276. Abstract available at http://muse.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/v019/19.1harrison.html

Study Explores Effects of Crash characteristics and Maternal Restraint on Fetal Outcomes After Motor Vehicle Crashes
"This study shows that proper use of a belt restraint [during a motor vehicle crash] by a pregnant occupant has a significant positive effect on fetal outcome," state the authors of an article published in the April 2008 issue of the American Journal of Obstetrics and Gynecology. The public health problem of fetal loss and injury from maternal involvement in motor vehicle crashes is difficult to quantify. Reliable statistics on fetal loss resulting from automotive trauma are not available because maternal involvement in crashes has not been consistently recorded on fetal death certificates. In addition, the pregnancy status of women involved in crashes has been tracked in national databases only since 1995. The purpose of the study described in this report was to conduct in-depth investigations of motor-vehicle crashes involving pregnant occupants, with a focus on determining how restraint conditions and specific crash characteristics affect fetal outcome. http://www.mchlibrary.info/alert/2008/alert042508.html#4

Review Examines Screening for Bacterial Vaginosis in Pregnancy
"New treatment trial data pooled with 2001 report data showed no benefit to screening and treating women who are asymptomatic for bacterial vaginosis if they had a low or average risk for preterm delivery for the outcomes of delivery before 37, 34, or 32 weeks; preterm, premature rupture of membranes; or low birth weight," state the authors of an article published in the February 5, 2008, issue of the Annals of Internal Medicine. Preterm birth rates have increased in the past decade, and strong epidemiologic evidence has suggested an association between bacterial vaginosis and preterm birth. After decades of research and with heightened awareness of measuring potential adverse effects of medications, evidence is emerging that the drug being used to treat bacterial vaginosis may, at some doses and for some populations, be triggering adverse pregnancy outcomes. At the same time, evidence suggests that inherent differences in populations, such as previous pregnancy complications, gestational age, ethnicity, or co-infection, may also influence which women are helped or harmed by screening and treatment for bacterial vaginosis. This review was conducted for the U.S. Preventive Services Task Force (USPSTF) to update its 2001 recommendations by examining the evidence on the value of screening for and treating bacterial vaginosis in reducing adverse pregnancy outcomes for asymptomatic women at low, average, and high risk for preterm delivery. http://www.mchlibrary.info/alert/2008/alert022908.html#1

Researchers Review Evidence on the Impact of Weight Gain Among Women During Pregnancy
Outcomes of Maternal Weight Gain presents findings from a systematic literature review focusing on evidence for the influence of gestational weight gain on birth, infant health, and maternal health outcomes. The report, published by the Agency for Healthcare Research and Quality, provides background information on weight gain recommendations and gestational weight gain patterns in the United States. Additional chapters contain information on the methods and results and a discussion of the findings. Selected topics include outcomes of gestational weight gain, confounders, and effect modifiers of outcomes of maternal weight gain, risks, and benefits of gestational weight gain recommendations, and anthropometrics of weight measurement during pregnancy. Limitations of the evidence base and review as well as future research directions are also discussed. The abstract and full report (large file) are available at http://www.ahrq.gov/clinic/tp/admattp.htm.

BREASTFEEDING

Does Breastfeeding Reduce the Risk of Pediatric Overweight?
This research to practice brief explores the relationship between breastfeeding and pediatric overweight. The brief can be found at: http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/breastfeeding_r2p.pdf [PDF; 1.28mb]

Breastfeeding-Related Maternity Practices at Hospitals and Birth Centers – United States, 2007
This report summarizes results of a 2007 CDC survey of maternity practices related to breastfeeding. The results can be found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5723a1.htm

Breastfeeding in the United States: Findings from the National Health and Nutrition Examination Surveys, 1999-2006
This report summarizes information on breastfeeding rates in the U.S. based on data from the 1999-2006 NHANES. To read the full report, please go to: http://www.cdc.gov/nchs/data/databriefs/db05.htm

PREGNANCY LOSS AND INFANT DEATH

Head Covering May Increase SIDS Risk
To read more go to: http://www.reuters.com/article/healthNews/idUSCOL26933320080602
State Analysis Assesses Relationship between Pre-pregnancy Maternal Obesity and Risk of Infant Death

"This analysis indicates that maternal obesity is associated with increased odds of infant death," state the authors of an article published in the July-August 2008 issue of Public Health Reports. Consistent with the increasing focus on weight and health outcomes for the general population, maternal pre-pregnancy weight is also being assessed for its impact on perinatal health outcomes. In March 2004, Florida implemented a revised birth record that includes maternal height and pre-pregnancy weight. The addition of these two measures made it possible to conduct population-based analyses using body mass index (BMI). The purpose of the analysis, as presented in the article, was to assess and quantify the relationship between pre-pregnancy BMI and risk of infant death for the 2004 Florida birth cohort.
http://www.mchlibrary.info/alert/2008/alert072508.html#2

Study Investigates Alcohol Consumption During Pregnancy and the Risk of Early Fetal Death
In this large retrospective cohort study of more than 650,000 pregnancies, we report elevated risks of stillbirth among mothers who admit to alcohol ingestion during pregnancy," state the authors of an article published in the August 2008 issue of Alcohol. Alcohol intake during pregnancy is correlated with myriad adverse birth outcomes. The validity of previous studies of the relationship between maternal alcohol intake and fetal death (i.e., stillbirth) has been questioned owing to study-design considerations, small sample sizes, errors in classification of exposure, and failure to account for confounding factors. Finally, most published studies of maternal drinking and fetal death do not distinguish between fetal deaths that occur at different stages of pregnancy. The article presents findings from a study to investigate the independent association between alcohol consumption during pregnancy and early fetal death using a large population-based data set. http://www.mchlibrary.info/alert/2008/alert072508.html#3

Study Explores Relationship Between Obesity and Neonatal Mortality in Black Women and White Women
"Our study found maternal obesity to be an independent risk factor for neonatal mortality among blacks but not whites," state the authors of an article published in the June 2008 issue of Obstetrics and Gynecology. During the previous two decades, the prevalence of obesity (particularly morbid or extreme obesity) has been rising continuously in the United States, especially among women. Currently, information on the association between obesity and neonatal survival is sparse. The study described in this article sought to estimate the effect of maternal obesity on neonatal survival using a data source that has consistently obtained pre-pregnancy body mass index (BMI) indices as well as infant survival data for almost two decades. Although the article focuses primarily on maternal obesity in general, the authors also examine gradation of obesity as well as obesity-related black-white disparity in neonatal survival. http://www.mchlibrary.info/alert/2008/alert062708.html

Authors Examine How Sudden or Unexpected Deaths May Be Particularly Difficult for Physicians
This national survey reveals that perinatal death has a profound effect on delivering obstetricians," state the authors of an article published in the July 2008 issue of Obstetrics and Gynecology. Virtually all obstetricians who deliver neonates encounter perinatal death. It is estimated that approximately 15% of pregnancies end in early losses (before 20 weeks' gestation), and 1.3% end in either fetal death (losses after 20 weeks but before delivery) or infant death (deaths in the first year of life). It is well known that a perinatal death has a significant effect on bereaved families, but little is known about how client deaths in general affect physicians and specifically about how fetal or infant deaths affect obstetricians. The article presents findings from a study to identify U.S. obstetricians' experiences with and attitudes about perinatal death, their coping strategies, and their beliefs about the adequacy of their training on this topic. http://www.mchlibrary.info/alert/2008/alert072508.html#4

Article Identifies Maternal and Infant Characteristics Associated with Infant Sleep Positioning
We found several infant and maternal characteristics that may help identify populations to be targeted for future sleep positioning interventions," state the authors of an article published in the August 2008 issue of the Journal of Pediatrics. Since the early 1990s, prone (stomach) sleep positioning has been a recognized risk factor for sudden infant death syndrome (SIDS). In December 1996, new evidence suggested that lateral (side) placement was associated with an increased risk of SIDS, compared with supine (back) placement. The American Academy of Pediatrics (AAP) task force 1992 recommendation that infants be placed to sleep in the supine position (which was updated in 1996 to state that the supine position is preferred over the lateral position) is believed to be largely responsible for the 40% reduction in the national incidence of SIDS that occurred between 1992 and 1997. The study described in this article aims to identify factors predictive of either infant prone or lateral sleep positioning.
http://www.mchlibrary.info/alert/2008/alert072508.html#5

ALCOHOL, TOBACCO AND OTHER DRUGS

Prevention of Tobacco Use and Secondhand Smoke Exposure Before, During, and After Pregnancy highlighted research, information, and programs at the national, state, and local levels on smoking cessation among pregnant and parenting women. The Web cast, presented on June 19, 2008, by the National Association of City and County Health Officials, included a discussion of systems-level approaches to smoking cessation among pregnant and parenting women, as well as the connection between environmental tobacco smoke and infant health. The Web cast archive is available at:
http://webcasts.naccho.org/session-archived.php?id=1446.

CHILD AND ADOLESCENT HEALTH

American Academy of Pediatrics Releases Online Version of Bright Futures Guidelines
Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents --Third Edition provides information to help pediatricians provide better health care, save time, and keep up with changes in families, communities, and society that impact infant, child, and adolescent health. The guidelines, recently made available for download from the American Academy of Pediatrics' Bright Futures Web site, are organized into 10 themes common to all stages of development, followed by specific guidance for each of 31 recommended health supervision visits from infancy through late adolescence. Growth charts and the newly revised periodicity schedule are included. The guidelines and reference information are available at:
http://brightfutures.aap.org/3rd_Edition_Guidelines_and_Pocket_Guide.html. Slides and handouts for use and customization in making presentations about Bright Futures are also available for download at: /http://brightfutures.aap.org/bright_futures_power_point_presentations.html

Influence of Multiple Social Risks on Children’s Health
This study examined the strength of association of 8 social risk factors on parent-reported child health status. The article is available from: http://www.pediatrics.org/cgi/content/full/121/2/337

Food Insecurity and Overweight Among Infants and Toddlers: New Insights into a Troubling Linkage
Child Trends Research Brief July 2007
This research brief draws upon recently released data to present a portrait of food insecurity among households with very young children in the U.S. The full report is available from: http://www.childtrends.org/files/Child_Trends-2007_07_11_RB_FoodInsecurity.pdf [PDF; 176 kb]

Food Security During Infancy: Implications for Attachment and Mental Proficiency in Toddlerhood
Data from a nationally representative sample of infants and toddlers were used to examine the direct and indirect associations between food insecurity at 9 months and attachment and mental proficiency at 24 months. This article is available at: http://www.springerlink.com/content/0q1174020t651nv0/fulltext.pdf [PDF; 318 kb]

Double Jeopardy: Depressive Symptoms and Rapid Subsequent Pregnancy in Adolescent Mothers
Study provides evidence that depression may be an important independent risk factor for rapid subsequent pregnancy in African-American adolescent mothers. The full article is available from: http://archpedi.ama-assn.org/cgi/reprint/162/3/246

Unplanned Pregnancy and Family Turmoil
Findings presented in this brief show that parents having a birth following an unplanned pregnancy are significantly less likely to be in a stable relationship and have significantly greater odds of experiencing conflict. This increased likelihood of turmoil and instability poses important risks to the well being of their children. To read the complete report, please go to: http://www.thenationalcampaign.org/resources/pdf/SS/SS34_FamilyTurmoil.pdf [PDF; 829 kb]

CHRONIC DISEASE PREVENTION

Kreuger, P.M. and Chang, V.W. Being Poor and Coping With Stress: Health Behaviors and the Risk of Death. May 2008, Vol 98, No. 5 | American Journal of Public Health 889-896.
The authors set out to examine whether smoking, alcohol use, and physical inactivity moderate the relationship between perceived stress and the risk of death in the US population as a whole and across socioeconomic strata. Data were derived from the 1990 National Health Interview Survey’s Health Promotion and Disease Prevention Supplement, which involved a representative sample of the adult US population (n=40335) and was linked to prospective National Death Index mortality data through 1997.

The authors found that high baseline levels of former smoking and physical inactivity increased the impact of stress on mortality in the general population as well as among those of low socioeconomic status (SES), but not middle or high SES.

The authors conclude that the combination of high stress levels and high levels of former smoking or physical inactivity is especially harmful among low-SES individuals. Stress, unhealthy behaviors, and low SES independently increase risk of death, and they combine to create a truly disadvantaged segment of the population.