Maternal and child health journal
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Matern Child Health J · Feb 2016
Do Children with Autism Overutilize the Emergency Department? Examining Visit Urgency and Subsequent Hospital Admissions.
Children with autism spectrum disorders (ASD) are more likely to have difficulties accessing health care compared to other children with special health care needs. National data based on parent report indicate that children with ASD are overutilizing emergency department (ED) services, but data on actual ED use has been limited to children with psychiatric diagnoses. This study examined factors associated with ED utilization (rate, urgency, and hospital admissions) among children with ASD compared to those without ASD. ⋯ Examination of predisposing, enabling, and reinforcing factors suggest that children with ASD were more likely to visit the ED and for nonurgent reasons.
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Matern Child Health J · Feb 2016
Observational StudyFactors Influencing Exclusive Breastfeeding in Early Infancy: A Prospective Study in North Central Nigeria.
To determine the association between prenatal exclusive breastfeeding intentions and exclusive breastfeeding (EBF) and explore other factors associated with EBF until 3 months postpartum among mothers residing in suburban parts of the Federal Capital Territory, Abuja Nigeria. ⋯ Prenatal exclusive breastfeeding intention was a strong predictor of exclusive breastfeeding. Intentions to EBF were further explained by maternal characteristics. Effective promotion of exclusive breastfeeding during prenatal period should also target factors influencing breastfeeding intentions. Additional research is warranted into the influence of maternal attitudes and self-efficacy about breastfeeding on breastfeeding intentions and practice.
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Matern Child Health J · Feb 2016
Do Socioeconomic Inequalities in Neonatal Mortality Reflect Inequalities in Coverage of Maternal Health Services? Evidence from 48 Low- and Middle-Income Countries.
To examine socioeconomic and health system determinants of wealth-related inequalities in neonatal mortality rates (NMR) across 48 low- and middle-income countries. ⋯ Reducing the financial burden of maternal health services and achieving universal coverage of antenatal care may contribute to a reduction in socioeconomic differences in NMR. Further investigation of the mechanisms contributing to these cross-national associations seems warranted.
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Matern Child Health J · Jan 2016
Intensive Care Admissions in Pregnancy: Analysis of a Level of Support Scoring System.
Development of a validated triaging system that can be used by obstetric providers to identify obstetric patients at risk of developing severe morbidity during an admission is urgently required. Maternal Critical Care Working Group (MCCWG) recommended a "level of care" strategy that based patient acuity needs on number of individual organ systems requiring support. The objective of this study was to apply the MCCWG level of support for critical care (MCCWG LOC) scoring to pregnant women admitted to an intensive care unit (ICU) to predict maternal outcomes and to compare it to the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system. ⋯ In a cohort of women requiring intensive care admission during pregnancy, MCCWG LOC, a simplified organ system based, triaging scoring system, predicted maternal outcomes and correlated with APACHE II score. Our data support initiatives for further development and testing of global obstetric triaging scoring systems for the purposes of risk stratification, monitoring of quality and resource allocation.
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Matern Child Health J · Sep 2015
Neonatal Mortality and Inequalities in Bangladesh: Differential Progress and Sub-national Developments.
A rapid reduction in under-five mortality has put Bangladesh on-track to reach Millennium Development Goal 4. Little research, however, has been conducted into neonatal reductions and sub-national rates in the country, with considerable disparities potentially masked by national reductions. The aim of this paper is to estimate national and sub-national rates of neonatal mortality to compute relative and absolute inequalities between sub-national groups and draw comparisons with rates of under-five mortality. ⋯ For mortality rates stratified by education and wealth mixed evidence suggests that relative inequalities may have also fallen. Although disparities remain, Bangladesh has achieved a rare combination of substantive reductions in mortality levels without increases in relative inequalities. A coalescence of substantial increases in coverage and equitable distribution of key child and neonatal interventions with widespread health sectoral and policy changes over the last 30 years may in part explain this exceptional pattern.