Matern Child Health J [JOURNAL]
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200 papers
Maternal Experiences and Challenges in Breastfeeding Infants with Tongue-Tie: A Systematic Review.
Rodriguez Lara F, Carnino JM, Levi JR
Matern Child Health J · 2025 Jul · PMID 40366606 · Publisher ↗
INTRODUCTION: Tongue-tie, clinically referred to as ankyloglossia, is a common condition characterized by an unusually short lingual frenulum and is associated with breastfeeding difficulties. Mothers of infants with ton...
INTRODUCTION: Tongue-tie, clinically referred to as ankyloglossia, is a common condition characterized by an unusually short lingual frenulum and is associated with breastfeeding difficulties. Mothers of infants with tongue-ties are at increased risk of not only painful breastfeeding and poor latching, but also increased maternal stress and decreased maternal-infant bonding. The purpose of this systematic review is to examine the literature on maternal experiences and wellbeing while feeding infants with tongue-ties. METHODS: We searched MEDLINE, Web of Science and EMBASE for relevant articles. Keywords "maternal experience" and "tongue-tie" were among those used. An independent review was conducted by two authors, and studies were included if they reflected maternal experiences beyond breastfeeding outcomes. RESULTS: We found 8 studies, including qualitative and quantitative studies, that described maternal experiences with breastfeeding tongue-tied infants. All studies noted an increase in physiologic symptoms such as nipple pain and bleeding, as well as psychological symptoms including stress and strained relationships. CONCLUSIONS: Our systematic review indicates that women breastfeeding infants with tongue-ties are at increased risk of breastfeeding complications which can result in maternal stress, frustration, and impaired mother-infant bonding. Early evaluation of tongue-tie as a potentially significant contributor to breastfeeding complications and early intervention is important in these mothers and would likely decrease these negative effects described. Further research is needed to determine which populations are most likely to benefit from early intervention and how to best address the issue.
Potential Impact of Maternal and Newborn Health Improvements in Afghanistan: Projection of Mortality to 2030.
Maruf F, Tappis H, Augustin R … +2 more , van den Akker T, Tam Y
Matern Child Health J · 2025 Jun · PMID 40358850 · Full text
BACKGROUND: Despite remarkable progress, Afghanistan's health sector continued to be hampered by chronic challenges undermining its performance including pervasive poverty and ongoing instability. At present, many pregna...
BACKGROUND: Despite remarkable progress, Afghanistan's health sector continued to be hampered by chronic challenges undermining its performance including pervasive poverty and ongoing instability. At present, many pregnant women remain vulnerable because of low access to antenatal care, postnatal care, and skilled birth attendance. OBJECTIVE: To illustrate the potential impact that continued improvements in maternal and neonatal health can have in terms of lives saved, and progress towards development goals. More nuanced modeling to consider the current quality of services is needed to inform resource mobilization and allocation decisions in a constrained fiscal space. RESULTS: If coverage of evidence-based neonatal and maternal interventions reaches 90% of those in need by 2030, the neonatal mortality rate would drop from 36 to 16 per 1,000 live births, and the maternal mortality ratio from 638 to 237 per 100,000 live births. These reductions would mostly be driven by increases in coverage of interventions during childbirth. CONCLUSION: Tenacity, innovation, reinvigorated commitment, and continued financial resources are critically needed from the international health community and local government to avoid needless deaths and save lives.
Characteristics of Interaction Between Caregivers and Children with Chronic Diseases in Oral Medication-Taking Situations: A Validation Study of the Interaction Rating Scale.
Yasumoto T, Yamamoto T, Ishii A … +2 more , Okuno H, Fujino H
Matern Child Health J · 2025 Jun · PMID 40353976 · Full text
INTRODUCTION: Caregiver-child interaction is essential for maintaining adaptive oral medication-taking behavior in children. To evaluate interactive behavior between children and caregivers, the Interaction Rating Scale...
INTRODUCTION: Caregiver-child interaction is essential for maintaining adaptive oral medication-taking behavior in children. To evaluate interactive behavior between children and caregivers, the Interaction Rating Scale (IRS), an observation-based instrument for evaluating the quality of caregiver-child interaction, can be applied via observation of interactions. This study examined the applicability of the IRS in oral medication-taking situations. METHODS: Sixty-six caregiver-child dyads were evaluated using the IRS. The reliability of the measure was evaluated using Cronbach's alpha for internal consistency and intra-class coefficient (ICC) for inter-rater reliability and test-retest reliability. The concurrent validity was evaluated using the Positive and Negative Parenting Scale and the Social Skills Scale for Preschool Children. RESULTS: The IRS total, caregiver, and child scores showed high internal consistency (α = 0.86-0.92), test-retest reliability (ICC = 0.76-0.80) and inter-rater reliability (ICC = 0.86-0.91). The IRS indices were partially associated with the Positive and Negative Parenting Scale and Social Skills Scale scores in the hypothesized directions. DISCUSSION: The results indicated the IRS is a reliable and validated instrument for measuring characteristics of caregiver-child interactions in medication-taking situations. Further studies may be helpful for validating the measure in wider patient groups and investigating the medication behavior of children.
COVID-19 Knowledge, Message Perceptions and Behaviors among Pregnant and Postpartum Women During the Early Months of the COVID-19 Pandemic in the United States.
Brown KK, Igenoza O, Gupta S … +2 more , Jean Pierre C, Anaman ZA
Matern Child Health J · 2025 Jun · PMID 40347377 · Full text
OBJECTIVES: This study examined the factors associated with COVID-19 knowledge, perceptions of COVID-19 messaging related to the perinatal population, and examined the association between COVID-19 knowledge and adherence...
OBJECTIVES: This study examined the factors associated with COVID-19 knowledge, perceptions of COVID-19 messaging related to the perinatal population, and examined the association between COVID-19 knowledge and adherence to COVID-19 preventive behaviors among pregnant and postpartum women during the first wave of the COVID-19 stay-at-home orders in the United States. METHODS: This was a cross-sectional online survey. A convenience sample of pregnant and postpartum women (18-49) were recruited from across the United States between April and June 2020-during the first wave of the COVID-19 stay-at-home orders. Crude and adjusted logistic regression analyses were performed to estimate odds ratios (OR) with 95% confidence intervals. RESULTS: Of the 584 participants, 22.8% correctly answered all COVID-19 knowledge questions and 85.8% correctly identified the primary COVID-19 symptoms. Participants with at least one chronic health condition (aOR = 0.60, 95% CI = 0.39, 0.94) and who were unmarried (aOR=, 95% CI = 0.43, 0.93) had a lower odds of correctly answering COVID-19 knowledge questions. 62% of participants reported COVID-19 messaging was consistent and 43.3% of participants reported being able to find enough COVID-19 information or resources for pregnant or postpartum women. Participants had high levels of adherence to preventive behaviors. Participants who avoided hosting small gatherings during stay-at-home orders were two time as likely to correctly answer COVID-19 knowledge questions (aOR=, (95% CI = 1.15,3.66). DISCUSSION: The findings underline the importance of prioritizing tailored educational and care needs among pregnant and postpartum people as early as possible during a global health emergency.
Differences in HPV Vaccine Information Usefulness and Understanding Between Parents With and Without a Child with Special Healthcare Needs.
Manganello JA, Murray RM, Lo WJ … +6 more , Chiang SC, Guan M, Klassen AC, Leader AE, Hill LT, Massey PM
Matern Child Health J · 2025 May · PMID 40343667 · Publisher ↗
INTRODUCTION: Youth HPV vaccination rates have yet to reach the national goal of 80 percent. One understudied population with respect to the HPV vaccine is youth with special healthcare needs. This study seeks to underst...
INTRODUCTION: Youth HPV vaccination rates have yet to reach the national goal of 80 percent. One understudied population with respect to the HPV vaccine is youth with special healthcare needs. This study seeks to understand differences in HPV vaccine health information preferences and ratings of narrative content of parents with children with special healthcare needs to inform future communication efforts to improve HPV vaccine rates. METHODS: A national sample of U.S. parents and caregivers (N = 512) were recruited through Qualtrics panels. Parents completed a survey about their oldest child aged 9-14. Parents who answered yes to "Does this child need or use more medical, mental health, or education services than most children who are the same age?" were classified as having an index child with special healthcare needs. The survey also measured social media use and information seeking, narrative engagement, and perceptions of usefulness and understanding of vaccine messages. RESULTS: Fifteen percent (N = 77) of parents indicated that their index child had special healthcare needs. These parents were more likely to have a male index child, report social media as a first source of health information, and report greater understanding of HPV vaccine information presented in the stimulus materials. There were no differences for most demographics, social media use, HPV vaccine information source, and perceived usefulness of the HPV vaccine information. CONCLUSION: Overall, parents in this sample with and without an index child with special healthcare needs are similar in terms of how useful they found the materials. Parents with children who have special healthcare needs may have a greater preference for accessing information on social media, and may be better able to understand narrative health messages.
Correction: Brief Scoping Review of Community Hubs for the Care of Pregnant Mothers and Their Infants.
Tsai J, Camacho A, Ganduglia-Cazaban C
Matern Child Health J · 2025 Jul · PMID 40332637 · Publisher ↗
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Fetal Cannabis Exposure and Neonatal Outcomes: A Systematic Review and Meta-Analysis.
Bailey A, Kerr W, Alhay Z … +6 more , Rom M, Hamilton S, Campbell J, Kuhn K, Thompson D, Reese JA
Matern Child Health J · 2025 May · PMID 40317448 · Publisher ↗
INTRODUCTION: Current literature addressing fetal cannabis exposure and neonatal outcomes is based on subjective measures with varying levels of significance. This systematic review and meta-analysis determined if neonat...
INTRODUCTION: Current literature addressing fetal cannabis exposure and neonatal outcomes is based on subjective measures with varying levels of significance. This systematic review and meta-analysis determined if neonates with fetal cannabis exposure have an increased odds of being born small for gestational age, low birth weight, admitted to the Neonatal Intensive Care Unit (NICU) immediately after delivery, and/or preterm. METHODS: To identify relevant articles, we searched five databases using standard search criteria. Two authors used the Newcastle-Ottawa Scale to exclude articles with a high risk of bias. To estimate the combined effect, we calculated pooled odd ratios (OR) with 95% confidence intervals (CI) using the Mantel-Haenszel method for dichotomous data. RESULTS: Of 3,390 original articles we identified through the search strategy, 13 met the inclusion criteria. This meta-analysis indicates that neonates with fetal cannabis exposure have higher odds of being small for gestational age (OR = 1.79; 95% CI = 1.24-2.59) and/or having a low birth weight (OR = 1.38; 95% CI = 1.05-1.89) compared to neonates without fetal cannabis exposure. The results regarding NICU admission and preterm birth were statistically inconclusive (NICU admission: OR = 1.38, 95% CI = 0.86-2.22; Preterm birth: OR = 1.29, 95% CI = 0.97-1.71). Although the odds ratios for these associations span one suggesting a null relationship, they have an upper bound that may be clinically relevant. DISCUSSION: Based on these findings, further research, as well as an evaluation of the current public health response, is warranted. Additional research is needed to identify the association between neonatal outcomes and specific nuances of fetal cannabis exposure, such as route of ingestion, frequency of use, dose consumed, and the timing of intrauterine exposure.
Association of Postpartum Cardiovascular Biomarkers with HIV Among Women with Recent Preeclampsia in Zambia.
Mukosha M, Lubeya MK, Mutale W … +3 more , Maposa I, Chi BH, Hatcher A
Matern Child Health J · 2025 May · PMID 40314856 · Publisher ↗
OBJECTIVES: Women recovering from preeclampsia with elevated vascular biomarkers have a higher risk of future cardiovascular diseases. We investigated whether HIV on treatment was associated with biomarkers of cardiovasc...
OBJECTIVES: Women recovering from preeclampsia with elevated vascular biomarkers have a higher risk of future cardiovascular diseases. We investigated whether HIV on treatment was associated with biomarkers of cardiovascular risk in the weeks following delivery. METHODS: We analyzed data from a six-month prospective cohort study conducted from January 2022 to June 2023. Following delivery and at six weeks postpartum, we measured cystatin C, high sensitivity C-reactive protein (hs-CRP), Interleukine-2 (IL-2), Interleukine-6 (IL-6) and Tumor necrosis factor-alpha (TNFa). A generalized linear regression model with Poisson distribution estimated the association between vascular biomarkers and HIV on treatment. RESULTS: This study included 75 participants with a median age of 29 years (interquartile range [IQR] = 27-34 years), with 35 (46.7%) living with HIV on ART and 40 (53.3%) HIV-negative. Women living with HIV on ART had higher levels of hs-CRP than HIV-negative women (4.68 mg/l vs 3.60 mg/l, p = 0.025) at six weeks. On the other hand, women living with or without HIV on ART had similar levels of cystatin C (0.78 mg/l vs 0.81 mg/l, p = 0.303), IL-2 (0.64 pg/ml vs 0.67 pg/ml, p = 0.131), IL-6 (0.64 pg/ml vs 0.64 pg/ml, p = 0.422), and TNFa (24.2 pg/ml vs 24.1 pg/ml, p = 0.346). Living with HIV while on ART was associated with an increased risk of presenting as hypertensive with elevated hs-CRP (aRR = 2.88, 95% CI: 1.09-7.60). CONCLUSIONS: Women living with HIV on ART had elevated hs-CRP but similar levels of other biomarkers after preeclampsia. Further studies are needed to explore the differential impact of HIV disease vs. antiretroviral treatment on inflammatory responses.
Factors that Contribute to Neonatal Mortality at a Community Hospital.
Pristell C, Huffstetler A, Budd S … +1 more , Mena F
Matern Child Health J · 2025 May · PMID 40310602 · Publisher ↗
OBJECTIVES: The prevalence of intrauterine fetal demise (IUFD) in the United States is 5.74 per 1000 live births. In Maryland, the prevalence is 6.75 per 1000 and occurs nearly twice as frequently in Black than in white...
OBJECTIVES: The prevalence of intrauterine fetal demise (IUFD) in the United States is 5.74 per 1000 live births. In Maryland, the prevalence is 6.75 per 1000 and occurs nearly twice as frequently in Black than in white populations. At MedStar Franklin Square Medical Center (MFSMC), Electronic Medical Records (EMR) show that IUFDs are 2.5 times greater in Black than white women. This analysis aims to identify factors that contribute to this health disparity. METHODS: We performed a retrospective chart review of deliveries at MFSMC between 2018 and 2020. Literature-supported variables were collected for all pregnancies that ended in IUFD. Using logistic regression models, these factors were analyzed to isolate predictors for IUFD and association with race. The same predictors were compared to those of women who delivered live infants during this period. RESULTS: Without adjustment, the odds of having an IUFD are 2.21 times higher for Black mothers than for white mothers at MFSMC. No other unadjusted odds ratios between comorbid risk factors and the chance of IUFD were significant. After adjusting for diabetes, growth restriction, substance abuse, and hypertension, the odds of having an IUFD are 2.31 times higher for Black than white mothers. CONCLUSIONS: Black mothers experience increased risk for IUFD, after controlling for other pertinent factors. This disparity should be addressed by reducing healthcare provider bias, increasing maternal health services, and providing comprehensive patient education.
The Impact of Logos on Intrastate Variation of Response Rates for the Pregnancy Risk Assessment Monitoring System in Nevada.
Owen RJ, Owen L, Karki R
Matern Child Health J · 2025 Jun · PMID 40299168 · Publisher ↗
INTRODUCTION: Survey response rates have varied for Nevada's administration of the Pregnancy Risk Assessment Monitoring System (PRAMS) across the state. The authors evaluated whether using different logos for survey dist...
INTRODUCTION: Survey response rates have varied for Nevada's administration of the Pregnancy Risk Assessment Monitoring System (PRAMS) across the state. The authors evaluated whether using different logos for survey distribution would impact response rates. METHODS: Using focus groups and an online survey, we asked how participants perceived three logos (which was the most likely to be opened, most trustworthy, and must credible). RESULTS: Results showed that the State seal would be the mostly likely opened, but they were likely to discard it if the envelope's contents were not official business. The University's logo was polarizing in some areas. CONCLUSIONS: A PRAMS-specific logo survey may be more effective, as it was seen as "inviting" and adequately described the contents of the envelope. Further research is needed to better explore the impact of logos on mail distributions for public health surveillance surveys.
Health on the Margins: A Qualitative Inquiry into Maternal Well-Being Among Bakerwal Tribes in Kashmir.
Shah IA, Gadda ZH, Ganayee SA … +3 more , Jahangir MS, Kumar HA, Shafi A
Matern Child Health J · 2025 May · PMID 40299167 · Publisher ↗
OBJECTIVE: This study examines the critical issue of maternal health among tribal women in developing countries, with a specific focus on the Bakerwal tribe in Kashmir. Tribal women encounter significant challenges, incl...
OBJECTIVE: This study examines the critical issue of maternal health among tribal women in developing countries, with a specific focus on the Bakerwal tribe in Kashmir. Tribal women encounter significant challenges, including poverty, restricted access to medical facilities, and inadequate maternal care. Understanding these barriers is essential for addressing maternal health disparities and improving healthcare interventions tailored to their unique socio-cultural and economic conditions. METHODOLOGY: The research was conducted among the Bakerwal community in Check Village, Anantnag, using a qualitative approach to explore maternal health experiences. Given the community's low literacy levels, restricted healthcare access, and limited social mobility, data were collected from 20 tribal women who had recently given birth. Employing purposive sampling and guided by the principle of data saturation, in-depth interviews were conducted with 12 Bakerwal women and 5 healthcare professionals specializing in maternal care. This approach facilitated a deeper understanding of the maternal health challenges within the cultural and socio-economic context of the community. RESULTS: The study reveals that Bakerwal tribal women are experiencing a transitional phase in maternal health, shaped by socio-economic and cultural challenges. Poverty restricts their ability to afford nutritious food, exacerbating malnutrition and related health risks. Limited awareness and deeply rooted cultural norms further hinder the integration of pregnancy into their daily lives. Financial constraints not only reinforce stereotypes but also contribute to infrequent hospital visits, limiting access to essential maternal healthcare. Despite their heightened vulnerability to health risks, significant barriers, including geographical isolation, inadequate healthcare infrastructure, and cultural apprehensions, continue to obstruct their access to timely medical treatment. CONCLUSION: The maternal health of Bakerwal tribal women in Kashmir faces significant challenges at the intersection of poverty, cultural norms, and limited healthcare access. Economic constraints, lack of awareness, and the marginalization of pregnancy within their lifestyle contribute to malnutrition, infrequent hospital visits, and heightened health risks. Caught between tradition and modernity, their maternal health remains vulnerable to systemic disparities. Addressing these issues requires culturally sensitive interventions, improved healthcare infrastructure, and targeted awareness programs to bridge existing gaps and ensure equitable maternal care.
Paternal Health and Health Behaviors During the Perinatal Period: Results from a Representative Survey of Fathers in Georgia, 2018-2019.
Dalal RM, Simon CD, Parker JJ … +3 more , Bendelow A, Bryan M, Garfield CF
Matern Child Health J · 2025 May · PMID 40299166 · Full text
OBJECTIVES: To investigate the associations between paternal sociodemographic characteristics, healthcare utilization and self-reported health status among a state-representative sample of fathers. METHODS: The Pregnancy...
OBJECTIVES: To investigate the associations between paternal sociodemographic characteristics, healthcare utilization and self-reported health status among a state-representative sample of fathers. METHODS: The Pregnancy Risk Assessment Monitoring System for Dads pilot study sampled 857 fathers in Georgia from October 2018-July 2019. It surveyed fathers 2-6 months after their infants' birth to assess paternal experiences and behaviors during the perinatal period. Multivariable logistic regression examined associations between paternal characteristics and three outcomes: having a primary care physician (PCP), having any personal healthcare visit, and self-reported health status. RESULTS: Among 266 respondents, 53.9% reported having a PCP, 46.2% reported any healthcare visit, and 65.2% reported very good or excellent health. Insured fathers were more likely to have a PCP (65.6% vs. 26.6%; adjusted Prevalence Ratio [aPR] = 2.47, 95% CI 1.41-4.33) and a healthcare visit (59.9% vs. 21.5%; aPR = 2.60, 95% CI 1.30-5.22) than fathers who were uninsured. Fathers with a college degree or higher were more likely to have a healthcare visit (59.4% vs. % 39.3%; aPR = 1.68, 95% CI 1.13-2.49), and to report very good or excellent health (79.1% vs. % 52.2%; aPR = 1.52, 95% CI 1.16-1.98) than fathers with a high school diploma/GED or less. Fathers reporting very good or excellent health were more likely to have a PCP (59.9% vs. 42.1%); aPR = 1.42, 95% CI 1.02-1.99) than fathers reporting fair or good health. CONCLUSIONS: Fathers' participation in healthcare was suboptimal. Identifying barriers impacting men's interactions with the healthcare system is essential to develop strategies to improve the overall health of fathers and families.
Postpartum Care Recommendations from Parents of Premature Infants Requiring Intensive Care.
Chen MJ, Kair LR, Schwarz EB … +4 more , Toland M, Rizzo J, Creinin MD, Chang JC
Matern Child Health J · 2025 Jun · PMID 40293610 · Full text
OBJECTIVE: To describe postpartum care preferences and experiences among individuals who deliver a premature infant requiring neonatal intensive care. METHODS: In this qualitative description study, we recruited patients...
OBJECTIVE: To describe postpartum care preferences and experiences among individuals who deliver a premature infant requiring neonatal intensive care. METHODS: In this qualitative description study, we recruited patients 2 to 8 weeks after delivery of a premature infant requiring neonatal intensive care to participate in semi-structured interviews. We asked participants to share their postpartum care experiences including their expectations and preferences regarding what is addressed during postpartum visits, their decision-making process in attending scheduled postpartum visits, and their suggestions for how to optimize postpartum care to serve their needs. We used thematic analysis to generate codes and identify themes. RESULTS: Of 26 participants, 8 (31%) had attended a postpartum visit, 4 (15%) had missed their appointment, and 14 (54%) had a visit scheduled to occur after the time of the study interview. We found that participants weigh the perceived benefits of attending a postpartum visit against barriers to care, such as insurance restrictions, competing responsibilities and priorities when deciding whether to attend their postpartum visit. At their postpartum visit, participants preferred when clinicians centered the visits around the participants' goals and tailored the encounter to their specific concerns. Lastly, participants recognize that screening for postpartum mood disorders is important; however, the current screening tools do not differentiate between mood disorders and expected responses to a stressful neonatal intensive care experience. CONCLUSIONS FOR PRACTICE: Postpartum visits tailored to patient preferences for care in the early postpartum period are needed alongside system-level interventions to address barriers to accessing postpartum care for patients who deliver premature infants.
Birth Outcomes Following Anti-viral Therapy for Treatment of COVID-19 During Pregnancy.
Yang H, Elsayed Y, Zablocki V … +1 more , Bailey B
Matern Child Health J · 2025 May · PMID 40287596 · Publisher ↗
INTRODUCTION: The aim of this pilot study was to examine, using observational data, birth outcomes following the use of antiviral therapy in pregnancy. METHODS: This retrospective chart review study involved patients dia...
INTRODUCTION: The aim of this pilot study was to examine, using observational data, birth outcomes following the use of antiviral therapy in pregnancy. METHODS: This retrospective chart review study involved patients diagnosed with COVID-19 who received care at a single university-affiliated obstetrics practice grouped as having received, or not received, Ritonavir-Boosted Nirmatrelvir (NMV-r). Participant background information and birth outcomes were extracted and analyzed. RESULTS: Of 141 patients, nine were prescribed and took a course of NMV-r. Infants born to patients who were pregnantand took NMV-r had significantly shorter hospital stays (average of 2.5 days less) compared to infants born to patients who did not take NMV-r. In addition, there were multiple non-significant but clinically meaningful group differences: more than 10% of those who did not take NMV-r delivered preterm, while all those who took NMV-r delivered after 37 weeks, and infants born to those who did not take NMV-r were three times more likely to be admitted to the NICU compared to infants born to those who took a course of NMV-r. CONCLUSION: Patients who are pregnant andtake NMV-r as treatment for COVID-19 appear to have better birth outcomes than those who do not, with no identified adverse effects in this small convenience sample. Based on this pilot study, NMV-r may improve clinical outcomes for obstetrics patients who contract COVID-19 during pregnancy.
Intrauterine Devices: Take Up and Discontinuation in a Time of Change.
Leiter V, Delaune G
Matern Child Health J · 2025 May · PMID 40281364 · Publisher ↗
OBJECTIVES: Intrauterine devices (IUDs) are a highly effective form of contraception. This paper examines who is more likely to use an IUD, who is more likely to discontinue IUD use due to dissatisfaction, and reasons fo...
OBJECTIVES: Intrauterine devices (IUDs) are a highly effective form of contraception. This paper examines who is more likely to use an IUD, who is more likely to discontinue IUD use due to dissatisfaction, and reasons for dissatisfaction, just before and after the Supreme Court's Dobbs decision that eliminated the federal right to abortion. METHODS: This study analyzes data from the 2017-2019 and 2022-2023 National Survey of Family Growth. Changes in IUD prevalence and removal for dissatisfaction were estimated. Logistic regression was used to examine IUD use and discontinuation due to dissatisfaction. Respondents' reasons for discontinuation were explored. RESULTS: IUD use increased very slightly but significantly, from 11.6 to 13.0%. Education, age, race, insurance status, living in a rural area, having given birth, and wanting any/more children were significant predictors of IUD use. The percentage of women who discontinued IUD use due to dissatisfaction decreased significantly, from 33.2 to 22.2%. Education and race/ethnicity were significant predictors of IUD removal. Most women who discontinued use due to dissatisfaction reported side effects. CONCLUSIONS FOR PRACTICE: IUDs are an increasingly important contraceptive method in the post-Dobbs era. However, we need to keep an eye on possible patient problems with the devices, particularly side effects such as pain, bleeding, and device migration, and educate patients on these possible side effects in advance of inserting an IUD. We also need to maintain users' ability to remove their IUDs if its benefits no longer outweigh its side effects, to preserve patient autonomy and well-being.
Rates of Sudden Unexpected Infant Death (SUID) and its Subcategories in the U.S.: The Effect of Maternal Race, Ethnicity and Nativity.
Branche T, Shapiro J, Najera C … +3 more , Matoba N, Rankin K, Collins JWJ
Matern Child Health J · 2025 May · PMID 40252172 · Publisher ↗
OBJECTIVE: This study aimed to estimate (1) rates of SUID and its subcategories among infants of U.S.-born and foreign-born women, and (2) the extent to which maternal race/ethnicity modifies the relationship between mat...
OBJECTIVE: This study aimed to estimate (1) rates of SUID and its subcategories among infants of U.S.-born and foreign-born women, and (2) the extent to which maternal race/ethnicity modifies the relationship between maternal nativity and SUID rates. METHODS: Stratified and adjusted (for traditional demographic, clinical, and behavioral risk factors) Poisson regression analyses were performed on the National Center for Health Statistics linked 2021-2022 live birth-infant death database. Rates of SUID and its subcategories-sudden infant death syndrome (SIDS), accidental suffocation or strangulation in bed (ASSB), and unknown causes-were calculated for infants of women in the four largest U.S. racial/ethnic groups. RESULTS: Infants of U.S.-born women (n = 5,600,507) had an over three-fold greater SUID rate than infants of foreign-born women (n = 1,594,547): 115.5/100,000 vs. 34.8/100,000, RR = 3.3 (3.0, 3.6). Strikingly, the nativity disparity existed among infants of Non-Hispanic Asian (n = 431,532), Non-Hispanic Black (n = 1,025,573), Hispanic (n = 1,820,734) and Non-Hispanic White (n = 3,722,820) women: RR = 2.4 (1.7, 3.5), 4.9 (4.0, 6.1), 2.3 (2.0, 2.6), and 3.2 (2.5, 4.1), respectively. Maternal nativity disparities in SUID persisted after adjustment, overall (adjRR = 2.5 (2.3, 2.8)) and within each racial/ethnic group. Non-Hispanic Black infants had the widest disparity (adjRR = 3.3 (2.7, 4.1)). Similar results were observed for SIDS, ASSB, and unknown causes. CONCLUSIONS FOR PRACTICE: Infants of U.S.- vs. foreign-born women have higher rates of SUID and its subcategories independent of traditional risk factors. This nativity disparity is widest among Non-Hispanic Black women. These findings warrant further attention and research regarding differences in environment, infant sleep practices and SUID death investigation among foreign-born and U.S.-born women.
Impact of Mediterranean Diet Adherence in Early Pregnancy on Nausea, Vomiting, and Constipation.
Barroso-Ruiz I, Cano-Ibáñez N, Benito-Villena R … +2 more , Martín-Peláez S, Amezcua-Prieto C
Matern Child Health J · 2025 May · PMID 40195164 · Full text
OBJECTIVES: Common maternal digestive symptoms, such as nausea, vomiting, and constipation during pregnancy, can impair pregnant women's quality of life. The Mediterranean diet (MedDiet), characterized by a high consumpt...
OBJECTIVES: Common maternal digestive symptoms, such as nausea, vomiting, and constipation during pregnancy, can impair pregnant women's quality of life. The Mediterranean diet (MedDiet), characterized by a high consumption of olive oil, vegetables, fruits, legumes, and grains; moderate fish and dairy intake; and low meat consumption, could alleviate these symptoms. This study aims to study the prevalence of maternal digestive symptoms in the different pregnancy trimesters and to examine the association between baseline MedDiet adherence and the prevalence of maternal digestive symptoms during pregnancy. METHODS: A secondary analysis of the Walking Preg_Project trial was conducted in a cohort of adult Spanish pregnant women (N = 237) who provided data about MedDiet adherence and maternal digestive symptoms (nausea, vomiting, constipation) at baseline (12th ), 19 and 32nd Gestational Week (GW). MedDiet adherence was appraised through a 13-item questionnaire and categorized into low, medium, and high adherence. Digestive symptoms were assessed by the Pregnancy Symptoms Inventory. The association between baseline MedDiet adherence and maternal digestive symptoms was evaluated through adjusted multinomial analysis. RESULTS: Differences among MedDiet adherence categories were considerable during pregnancy. Some of the greatest decreases were observed in high adherence to MedDiet in comparison with low MedDiet adherence at 32nd GW vs. 19th GW for the prevalence of nausea (10.0% vs. 18.8%, p < 0.001) and vomiting (5.0% vs. 8.7%, p < 0.001). Constipation remained during pregnancy. There was no significant association between the baseline MedDiet adherence and maternal gastrointestinal symptoms. CONCLUSION FOR PRACTICE: Baseline adherence to the MedDiet was not proven to influence nausea, vomiting, and constipation during pregnancy. For all MedDiet adherence groups, nausea and vomiting prevalence decreased throughout pregnancy, but not constipation.
Public Insurance Eligibility Thresholds and Receipt of Mental Health Services among Childen from Households with Low Incomes.
Zhang YX, Wilk AS, Cummings JR
Matern Child Health J · 2025 Apr · PMID 40195163 · Publisher ↗
INTRODUCTION: Only half of U.S. children with mental health conditions receive treatment annually, and children from lower-income households face greater barriers to treatment. Medicaid and the Children's Health Insuranc...
INTRODUCTION: Only half of U.S. children with mental health conditions receive treatment annually, and children from lower-income households face greater barriers to treatment. Medicaid and the Children's Health Insurance Program (CHIP) facilitate children and families to access mental health services by providing government-funded insurance coverage. However, household income eligibility thresholds for children in Medicaid and CHIP vary greatly across states, and children from low-income households in states with a higher threshold are more likely to access healthcare. Using national data, we examine the relationship between eligibility thresholds across Medicaid and CHIP and receipt of mental health services among children from low-income households. METHODS: We used data from the 2016-2020 National Survey of Children's Health to identify children ages 6-17 with household incomes below 400% of the federal poverty line. We conducted multivariable logistic regressions to estimate the associations between eligibility thresholds and children's (1) use of any mental health services as well as (2) caregiver-reported unmet mental health need in the past year. RESULTS: Controlling for child, family, and state characteristics, we did not find a significant relationship between eligibility thresholds and use of any mental health services. However, we found that a one standard deviation increment in the eligibility threshold above the mean was associated with 20% lower odds of caregiver-reported unmet mental health need (OR: 0.79, p < 0.01). DISCUSSION: More generous eligibility thresholds in Medicaid and CHIP are associated with less unmet need for mental health care among children from families with low incomes.
Single-Parent Births in California: A Population-Based Examination of the Risk of Child Protective Services Involvement.
Palmer L, King B, Eastman AL … +3 more , Ahn E, Reddy J, Putnam-Hornstein E
Matern Child Health J · 2025 May · PMID 40183997 · Publisher ↗
OBJECTIVES: The current study examined differential rates of child protective services (CPS) involvement between infants with one or two legally established parents at birth. METHODS: Vital birth records were used to doc...
OBJECTIVES: The current study examined differential rates of child protective services (CPS) involvement between infants with one or two legally established parents at birth. METHODS: Vital birth records were used to document all children with a registered birth in California in 2017 (N = 470,854). This birth cohort was then prospectively followed in linked CPS records through age 1 year. RESULTS: Birth records indicated that 7.1% of infants (n = 33,597) had only one legally established parent. Adjusting for sociodemographic factors, infants with only one parent documented on the birth record were more than twice as likely to be reported for maltreatment (IRR = 2.20; 99% CI [2.12, 2.29]). In the overall birth cohort, significant differences in the likelihood of a CPS report were observed by parental sociodemographic factors (education, age, public insurance, race and ethnicity); however, these same factors were attenuated, to varying degrees, among infants with a single legal parent. CONCLUSIONS FOR PRACTICE: Infants born with a single legal parent had a higher concentration of factors associated with heightened rates of CPS involvement. Assessing the circumstances associated with single parenthood, such as understanding household composition and who is involved in the infant's care, may explain potential vulnerability and identify service needs.
A Qualitative Study To Understand Parental, Health Care Provider and WIC Nutritionist Perspectives on Early Childhood Beverage Choices for WIC-enrolled Families in a Southeastern US Health System.
Ali S, Gibbs SE, Wiseman K … +6 more , Zoellner J, Montez K, Taxter A, Suarez M, Hindel L, Lewis KH
Matern Child Health J · 2025 May · PMID 40167858 · Full text
OBJECTIVES: Nutritionists for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), along with healthcare providers, can influence beverage choices for young children in WIC-enrolled families...
OBJECTIVES: Nutritionists for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), along with healthcare providers, can influence beverage choices for young children in WIC-enrolled families. Coordination of messaging about beverages and between-provider communication may be important for facilitating behavior change. METHODS: In preparation for a planned intervention, during Spring through Fall of 2021, we conducted a qualitative study to understand perceptions around family beverage choice discussions across three groups: parents of WIC-enrolled children, WIC nutritionists and practicing clinicians. Semi-structured interviews were conducted with 25 individuals, with sample size determined a priori. Thematic content analysis was used to summarize transcribed data. RESULTS: There was broad agreement that children should not consume sugar-sweetened beverages (SSB), but disagreement on tap water safety. Both clinicians and WIC nutritionists reported educating families about healthy drink choices, and parents recalled similar messages during these conversations. Parents were very supportive of fruit juice as part of the WIC package, with near universal opposition among clinicians. Many parents expressed concerns about tap water. Both provider groups perceived difficulty in reaching out to each other, and felt more communication would be helpful. CONCLUSIONS FOR PRACTICE: Our findings highlight a need for more regular communication between WIC nutritionists and children's healthcare providers within our system, and more consistent parental education on juice and tap water safety. Future studies could evaluate whether these types of communication gaps and perceptions are regional or more widespread across the US.
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