Maternal and child health journal
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Matern Child Health J · Oct 2013
Maternal pre-pregnancy BMI, gestational weight gain, and age at menarche in daughters.
Life course theory suggests that early life experiences can shape health over a lifetime and across generations. Associations between maternal pregnancy experience and daughters' age at menarche are not well understood. We examined whether maternal pre-pregnancy BMI and gestational weight gain (GWG) were independently related to daughters' age at menarche. ⋯ The association between maternal pre-pregnancy weight and daughters' menarcheal timing was not mediated by daughter's birth weight, prepubertal BMI or maternal GWG. Maternal factors, before and during pregnancy, are potentially important determinants of daughters' menarcheal timing and are amenable to intervention. Further research is needed to better understand pathways through which these factors operate.
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Matern Child Health J · Oct 2013
Racial disparities in economic and clinical outcomes of pregnancy among Medicaid recipients.
To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. ⋯ Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes.
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Matern Child Health J · Oct 2013
What will it take to maintain the maternal and child health gains made in Haiti prior to the 2010 earthquake?: an analysis of past progress, trends, and the prospects for the realization of the United Nations Millennium Development Goals 4 and 5.
This report assesses the commendable progress made in maternal and child mortality reductions in Haiti prior to the January 2010 earthquake. Suggested measures that the Haitian government and international donor community can take to maintain these gains are also made. With the Millennium Development Goals (MDGs) deadline of 2015 drawing nearer, the likelihood that Haiti will achieve MDG's 4 and 5 of reducing child and maternal mortality by two-thirds and three-quarters, respectively, by the end of this target year, remain questionable. ⋯ Post-quake public health and social service reconstruction efforts will need to incorporate maternal and child health-friendly services into their designs. It also remains critical that international donors continue to meet their pledges to Haiti. The Haitian government should also take more strides to clearly delineate the maternal and child health interventions it implements, both in order to facilitate greater national learning, as well as to improve the likelihood of future replication.
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Matern Child Health J · Sep 2013
Evaluation of a parent led curriculum in developmental disabilities for pediatric and medicine/pediatric residents.
Families of children with special health care needs (CSHCN) want to partner with their physicians to provide family-centered care and a medical home for their children. A parent group independently developed a parent-led curriculum to assist in the training of residents for this purpose. The objective of this study was to evaluate pediatric residents' satisfaction with and perceived relevance of this parent-led curriculum demonstrating the effects a disability has on the child and family. ⋯ Pediatric residents rated this parent-led curriculum "very good" to "excellent" overall. Residents were highly satisfied with all areas assessed and felt that it was relevant to their future practices. Parent-led curricula regarding care of children with disabilities can be incorporated into and enhance pediatric resident training programs.
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Matern Child Health J · Aug 2013
Maternal pre-gravid obesity and early childhood respiratory hospitalization: a population-based case-control study.
Inflammation in utero is linked to childhood respiratory and infectious complications. Obesity is an increasingly common chronic inflammatory state, yet little is known about its role in childhood respiratory illness. We sought to examine the association between maternal pre-gravid BMI and early childhood respiratory hospitalization. ⋯ An elevated maternal pre-gravid BMI was associated with increased risk of childhood respiratory hospitalization, with an adjusted odds ratio OR [95 % CI] = 1.08 [1.03-1.14] for overweight mothers (BMI 25-29.9 kg/m(2)), and OR = 1.29 [1.22-1.36] for obese mothers (BMI ≥ 30 kg/m(2)). An elevated maternal pre-gravid BMI was associated with higher risk of early childhood respiratory hospitalization. Childhood respiratory illness may be an important complication of excess maternal weight that should be shared with expectant mothers.