Maternal and child health journal
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Matern Child Health J · Feb 2015
Comprehensive review of sleep-related sudden unexpected infant deaths and their investigations: Florida 2008.
To describe 2008 Florida sleep-related sudden unexpected infant deaths (SUIDs) by describing (a) percentage distribution of medical examiner (ME) cause-of-death determinations; (b) mortality rates by maternal and infant characteristics; (c) prevalence of selected suffocation or sudden infant death syndrome (SIDS) risk and protective factors; (d) frequency of selected scene investigation and autopsy components (including extent of missing data); and (e) percentage with public health program contact. In this population-based study, we identified sleep-related SUIDs occurring among Florida residents from the 2008-linked Florida infant death and birth certificates. Information about the circumstances of death was abstracted from ME, law enforcement, and hospital records. ⋯ Effective interventions are needed to promote safe sleep among caregivers of Florida infants. These interventions must reach infant caregivers at highest risk and change unsafe sleep practices. The substantial percentage of missing investigation data reinforces the need for standardized reporting.
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Matern Child Health J · Jul 2014
Positive childbirth experiences in U.S. hospitals: a mixed methods analysis.
Research on maternity care quality in the US often focuses on avoiding adverse events. Positive birth experiences receive less attention. This analysis used a mixed methods approach to identify factors associated with confidence and positive experiences during birth among a national sample of U. ⋯ Black and Hispanic race/ethnicity (compared to white) and having partner support were positively associated with confidence during birth for nulliparous women. Qualitative analyses revealed that positive experiences were related to previous birth experiences, communication between women and their clinicians, perceptions of shared decision-making, and communication among clinicians related to the timing and logistics of managing complications and coordinating care. For clinicians who care for women during pregnancy and childbirth, thoughtful, deliberate attention to factors promoting positive birth experiences may help create circumstances amenable to enhancing the quality of obstetric care and improving outcomes for mothers and infants.
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Matern Child Health J · Jul 2014
Randomized Controlled TrialDoes additional prenatal care in the home improve birth outcomes for women with a prior preterm delivery? A randomized clinical trial.
Women with a history of a prior preterm birth (PTB) have a high probability of a recurrent preterm birth. Some risk factors and health behaviors that contribute to PTB may be amenable to intervention. Home visitation is a promising method to deliver evidence based interventions. ⋯ Intervention participants had a shorter intrapartum length of stay. Enhanced prenatal care by nurse-midwife home visits may limit some risk factors and shorten intrapartum length of stay for women with a prior PTB. This study contributes to knowledge about evidence-based home visit interventions directed at risk factors associated with PTB.
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Matern Child Health J · May 2014
Comparative StudySocioeconomic and geographical disparities in under-five and neonatal mortality in Uttar Pradesh, India.
As a part of the Millennium Development Goals, India seeks to substantially reduce its burden of childhood mortality. The success or failure of this goal may depend on outcomes within India's most populous state, Uttar Pradesh. This study examines the level of disparities in under-five and neonatal mortality across a range of equity markers within the state. ⋯ Of concern are also the signs of stagnation in mortality amongst groups with greater ability to access services, such as the urban middle class. Notwithstanding the slow but steady reduction of absolute levels of childhood mortality within Uttar Pradesh, the distribution of the mortality by sub-state populations remains unequal. Future progress may require significant investment in quality of care provided to all sections of the community.
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Matern Child Health J · Apr 2014
California Pregnancy-Associated Mortality Review: mixed methods approach for improved case identification, cause of death analyses and translation of findings.
After several decades of declining rates, maternal mortality climbed in California from a three-year moving average of 9.4 deaths per 100,000 live births in 1999-2001 to a high of 14.0 deaths per 100,000 live births in 2006-2008 (p < 0.001). The Maternal, Child and Adolescent Health Division of the California Department of Public Health developed a mixed method approach to identify and investigate maternal deaths to inform prevention strategies. This paper describes the methodology of the California Pregnancy-Associated Mortality Review (CA-PAMR) and its advantages for improved surveillance, cause of death analysis, and translation of findings. ⋯ Cardiovascular disease emerged as the leading cause of pregnancy-related deaths (20%), and African-American women were disproportionately represented among cardiovascular deaths. Overall, the chance to prevent the fatal outcome appeared good or strong in 40% of cases reviewed. The CA-PAMR methodology resulted in additional case finding, improved accuracy of the causes of pregnancy-related deaths, and evidence to guide development of prevention and quality improvement efforts.