Maternal and child health journal
-
Matern Child Health J · Jul 2018
Maternal Care Providers' Barriers Regarding Influenza and Pertussis Vaccination During Pregnancy in Catalonia, Spain.
Objective Maternal care providers (MCPs), obstetrician-gynaecologists and midwives are uniquely placed to increase maternal vaccination acceptance. We aimed to assess their knowledge, attitudes and practices regarding influenza and pertussis vaccination during pregnancy. Methods We conducted an online survey among MCPs working at "Attention to Sexual and Reproductive Health" (ASSIR) Units in Catalonia region. ⋯ The most popular strategies were: including vaccine recommendations in the pregnancy booklet (93.8%) and receiving vaccination training (92.3%). In the adjusted analysis, the only factor significantly associated with MCPs' prescription of influenza vaccine during second/third trimester was having been vaccinated themselves (odds ratio 3.70, 95% confidence interval 1.3-13.2). Conclusions for Practice Implementation of practical tools, continuous training and clear definition of responsibilities regarding vaccination among MCPs may have a significant impact on maternal vaccination coverage.
-
Matern Child Health J · Jul 2018
Interpregnancy Interval and Risk of Adverse Pregnancy Outcomes: A Register-Based Study of 328,577 Pregnancies in Denmark 1994-2010.
Objectives To investigate the associations of interpregnancy interval (IPI) with miscarriage, stillbirth, preterm delivery and small for gestational age delivery. Methods The study population comprised all women who had a live birth and at least one subsequent pregnancy in Denmark during the period from 1994 to 2010 (N = 328,577). Linear regression was used to estimate risk differences for miscarriage, stillbirth, preterm delivery and small for gestational age delivery according to IPI. ⋯ U-shaped associations were seen for preterm delivery and small for gestational age delivery with women with IPIs of 18-23 months experiencing the lowest risks of these outcomes. Conclusions for Practice The heterogeneity in associations between IPI and adverse pregnancy outcomes suggests that different mechanisms of action may be at play at various times in the antepartum period. While the finding for miscarriage suggests that fecundity is an important determinant for IPI, the findings for preterm delivery and small for gestational age delivery suggest the coexistence of the maternal depletion syndrome mechanism and the physiological regression mechanism and the finding for stillbirth speaks against a strict maternal depletion syndrome explanation.
-
Matern Child Health J · Apr 2018
Comparative StudyMedia and Young Minds: Comparing State Screen Media Use Regulations for Children Under 24 Months of Age in Early Care and Education to a National Standard.
Introduction Excessive screen media use has been associated with a number of negative health outcomes in young children, including increased risk for obesity and comparatively lagging cognitive development. The purpose of this study was to assess state licensing regulations restricting screen media use for children under 24 months old in early care and education (ECE) and to compare regulations to a national standard. Methods We reviewed screen media use regulations for all US states for child care centers ("centers") and family child care homes ("homes") and compared these regulations to a national standard discouraging screen media use in children under 24 months of age. ⋯ The year of last update (within the past 5 years versus older than 5 years) was not associated with regulations for centers (p = 0.18) or homes (p = 0.90). Discussion Many states lacked screen media use regulations for ECE. States should consider adding screen media use restrictions for children under 24 months based on current research data and current recommendations in future regulations updates.
-
Matern Child Health J · Apr 2018
Preliminary Psychometric Testing of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) in Portuguese Women.
Introduction Postpartum depression (PPD) is a prevalent condition with a serious impact. The early identification of women at risk for developing PPD allows for primary prevention and the delivery of timely appropriate referrals. This study investigated the validity and reliability of the postnatal version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R), an instrument widely studied internationally, in Portuguese women. ⋯ When using the EPDS > 9 cut-off score, the exploratory analyses yielded a sensitivity of 76.8% and a specificity of 73.0% with a cut-off score of 5.5 [area under the curve = 0.816]. Discussion These preliminary findings encourage the use of the postnatal version of the PDPI-R as a screening tool to identify Portuguese women at high risk for developing PPD. Subsequent assessments are needed to support the routine application of the PDPI-R both in research and for clinical purposes.
-
Matern Child Health J · Mar 2018
Factors Associated with Vaccination Status of Children Aged 12-48 Months in India, 2012-2013.
Objectives India has more unvaccinated children than any other country despite provision of free vaccines through the government's Universal Immunization Program. In this study, we calculated the proportion of children aged 12-48 months who were fully vaccinated, under-vaccinated, or who had not received any vaccines. Childhood, household, and sociocultural factors associated with under-vaccination and non-vaccination were evaluated. ⋯ Compared to children born in government institutions, children delivered in non-institutional settings with a skilled birth attendant present had higher odds of non-vaccination (OR 1.66) and those without a skilled attendant present had still greater odds of non-vaccination (OR 2.39) and under-vaccination (OR 1.11). Conclusions for Practice India's vaccination rates among children aged 12-48 months remains unacceptably low. The Indian government should encourage institutional delivery or birthing with a skilled attendant to ensure women receive adequate health education through antenatal care that includes the importance of childhood vaccination.