Matern Child Health J [JOURNAL]
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200 papers
Changes in Antenatal Obstetric Hospitalizations During the COVID-19 Pandemic in Western Sydney, Australia: A Population-Based Study.
Trinh LTT, Guevarra VM, Eljiz K
Matern Child Health J · 2026 May · PMID 42096171 · Publisher ↗
BACKGROUND: Information regarding the prevalence of antenatal obstetric hospitalizations (AOHs) before and during the COVID-19 pandemic is limited. AIMS: To examine changes in AOH prevalence, severity, emergency status,...
BACKGROUND: Information regarding the prevalence of antenatal obstetric hospitalizations (AOHs) before and during the COVID-19 pandemic is limited. AIMS: To examine changes in AOH prevalence, severity, emergency status, emergency department use, length of stay, causes, and associated maternal characteristics. METHODS: Routinely collected data from a tertiary referral hospital were analysed for January 2018-February 2020 (pre-pandemic) and from March 2020-April 2022 (during the pandemic). FINDINGS: AOHs decreased from 1,721/10,359 births (16.6%) pre-pandemic to 1,393/9,714 births (14.3%) during the pandemic (odds ratio [OR] = 0.84; 95% confidence interval [CI] = 0.78-0.91). Reductions were observed in overnight stays (- 2.6%), emergency admissions (- 2.2%), and emergency department involvement (- 1.4%). Mean length of stay decreased by 0.5 days. Pre-pandemic, women aged 35 and older, Indigenous women and women from Sub-Saharan Africa had higher rates of AOH, whereas women from Southern Asia had lower rates. During the pandemic, women aged 24 and younger and those from North Africa and the Middle East had higher rates, whereas women from Southern and Northeast Asia, those requiring an interpreter, and those living in less disadvantaged areas had lower rates. Smokers had higher rates both before and during the pandemic. CONCLUSIONS: AOH rates declined during the COVID-19 pandemic alongside reduced hospital utilization. These changes may reflect shifts in care-seeking and service delivery, including public health restrictions and telehealth use. Variation across population groups suggests differences in access to and use of care. Ongoing monitoring is needed to ensure reduced utilization does not reflect unmet need.
Prenatal Care Barriers Among Immigrant Women in Canada: A Scoping Review.
Ogunrinde D, Asayah S, D'Arcy C … +3 more , Mutwiri G, Feng C, Alphonsus K
Matern Child Health J · 2026 May · PMID 42089941 · Publisher ↗
OBJECTIVES: Immigrants in Canada make up more than 20% of the population. Despite the growing number of immigrants in the country, there remain gaps in culturally competent and adequate healthcare for immigrant mothers....
OBJECTIVES: Immigrants in Canada make up more than 20% of the population. Despite the growing number of immigrants in the country, there remain gaps in culturally competent and adequate healthcare for immigrant mothers. The main objective of this study was to identify the gaps in prenatal care of immigrant women in Canada. METHODS: A scoping review was carried out using Embase, Medline and PsycINFO between 2011 and 2022. Information on barriers to prenatal care was extracted. Only studies that were carried out in Canada and in English were included in the review. The methodological framework for the scoping review was adapted from Arksey and O'Malley. RESULTS: A total of 17 articles were included in the study after inclusion and exclusion criteria were met. Cultural and institutional factors affected mothers' access to prenatal healthcare, as well as perception of prenatal care in the Canadian healthcare system. Common obstacles were cultural, community capacity, and personal agency. CONCLUSION: Having culturally competent healthcare and more focus on service needs tailored for different ethnic groups in rural and remote areas could reduce barriers to prenatal care for immigrant women in Canada.
Does Quality of Prenatal Care for Black Birthing Women Impact Social Media Use?
George N, Reynolds S, de Long R … +3 more , Ahmed R, Kacica M, Manganello JA
Matern Child Health J · 2026 May · PMID 42084810 · Publisher ↗
OBJECTIVES: To examine the relationship between perceived prenatal care quality and social media use for pregnancy-related information among Black women in the United States during their most recent pregnancy. METHODS: T...
OBJECTIVES: To examine the relationship between perceived prenatal care quality and social media use for pregnancy-related information among Black women in the United States during their most recent pregnancy. METHODS: This cross-sectional study used a national sample of Black women who were pregnant or recently postpartum. Prenatal care quality was assessed using the Anticipatory Guidance and Support and Respect subscales of the Quality of Prenatal Care Questionnaire. Social media use measures included frequency of use, use for giving and getting support, and sharing pregnancy-related information. Multivariable linear regression models adjusted for demographic and provider-related factors. RESULTS: Participants rated prenatal care guidance quality as moderately good (mean item score: 3.86, SD: 0.85) and support and respect quality as high (mean item score: 4.09, SD: 0.88). Greater perceived prenatal care guidance quality was associated with social media use (r = 0.246, p < 0.0001) and use of social media for support (r = 0.272, p < 0.0001), and these associations remained significant after adjustment. Associations between support and respect quality and social media use observed in bivariate analyses were not significant in adjusted models. Both guidance quality and support and respect quality were associated with increased sharing of pregnancy-related information found on social media. Effect sizes were small. CONCLUSION: Social media is a routine source of pregnancy-related information among Black women, regardless of prenatal care experiences. Higher perceived guidance quality is associated with greater engagement in social media, though causality cannot be determined. Integrating discussions of online information into prenatal care may support informed decision-making and help reduce exposure to misinformation.
The Adaptation of the Perceived Obstetric Violence Scale in Students to Turkish Culture and an Examination of Its Psychometric Properties.
Unutkan A, Baris VK
Matern Child Health J · 2026 May · PMID 42084809 · Publisher ↗
BACKGROUND: Since the awareness of obstetric violence is generally low among individuals, many health professionals remain unaware of such incidents, even though they may witness them. OBJECTIVE: This study aimed to adap...
BACKGROUND: Since the awareness of obstetric violence is generally low among individuals, many health professionals remain unaware of such incidents, even though they may witness them. OBJECTIVE: This study aimed to adapt 'The Perceived Obstetric Violence Scale in Students' to Turkish culture, and to evaluate its validity and reliability. DESIGN: The study has a cross-sectional design. METHOD: A total of 222 midwifery, nursing, and medical students are recruited to the study. Random sampling was used, and data were collected using an online survey method. The reliability of the scale was assessed by calculating Cronbach's α coefficient, two-half-test reliability, and item-total score correlation (Pearson) values. Confirmatory factor analysis and criterion validity were used to assess validity. RESULTS: The mean age of the participants was 21.59 ± 1.32 years; 82.9% were female, 44.1% were nursing students, 63.5% had never heard of obstetric violence, and 80.2% thought that women of different economic status were treated differently during labor. Within the scope of reliability analyses, Corrected Item-Total Correlation Values were calculated between 0.102 and 0.682, and Cronbach's coefficient was calculated as 0.932. The results from the confirmatory factor analysis and tests of criterion validity support the validity of the scale's original two-factor structure in the Turkish version. CONCLUSION: The results of this study support that the Turkish version of the 'The Perceived Obstetric Violence Scale in Students' is both valid and reliable. However, some limitations were identified, suggesting that further validation and reliability testing with a larger sample size could be beneficial in future studies.
Barriers and Needs for Postpartum Contraception.
Spishak-Thomas A, Eliason EL
Matern Child Health J · 2026 May · PMID 42081137 · Full text
OBJECTIVES: Family planning after childbirth can address postpartum individuals’ contraceptive needs and preferences for birth spacing. Our study explored the reasons for not using postpartum contraception and identified...
OBJECTIVES: Family planning after childbirth can address postpartum individuals’ contraceptive needs and preferences for birth spacing. Our study explored the reasons for not using postpartum contraception and identified opportunities to remove contraceptive barriers. METHODS: This study used the 2019–2021 Pregnancy Risk Assessment Monitoring System survey of individuals with a recent live birth in 40 states, New York City, and the District of Columbia. We used mixed-methods to analyze categorical and free-text responses on the reasons for not using postpartum contraception. Descriptive and bivariate analysis were applied to characterize the data and explain the relationship between variables. Qualitative data was processed by manual coding procedures. RESULTS: Among the 115,917 sample respondents, 22.9% reported not using contraception in the postpartum period. The most common responses were not wanting to use birth control (39.3%) and concerns about contraceptive side effects (32.2%). There were 4,508 postpartum people who completed a free-text response and primarily reported not using contraception due to difficulties with appointment processes and/or not enough time, and infertility or trouble conceiving. CONCLUSIONS FOR PRACTICE: We find that postpartum people predominantly reported not wanting to use birth control, contraceptive side effects, infertility, and appointment processes, as reasons for not taking actions to prevent pregnancy. These findings suggest a need for additional counseling about side effects and benefits of contraception and can inform policies and practices that promote reproductive health equity in the postpartum period.
Low Influenza Vaccine Awareness and Uptake Among Pregnant Women in Split-Dalmatia County, Croatia: A Cross-sectional Survey.
Caktaš Pletikosić P, Došenović S
Matern Child Health J · 2026 May · PMID 42070206 · Publisher ↗
OBJECTIVE: Pregnant women face increased risks from influenza complications, underscoring the importance of vaccination. This study evaluated knowledge and attitudes about influenza vaccination and self-reported vaccinat...
OBJECTIVE: Pregnant women face increased risks from influenza complications, underscoring the importance of vaccination. This study evaluated knowledge and attitudes about influenza vaccination and self-reported vaccination rates among pregnant women in Split-Dalmatia County, Croatia. METHODS: A cross-sectional study was conducted from March to July 2020 in primary healthcare gynecological clinics in Split, Croatia. A convenience sample of pregnant women completed an anonymous 33-question survey after providing informed consent. Data were analyzed with a chi-square test, Fisher's exact test, or Kruskal-Wallis test, as appropriate. RESULTS: Among 323 participants, only 10 (3.2%) received the influenza vaccine during pregnancy. Most respondents (96.3%) reported that healthcare providers did not offer them influenza vaccine. Insufficient knowledge about influenza vaccination was observed, with a median score of 38.46 (IQR = 23.08-53.85) out of 100. Higher education was significantly associated with better knowledge about influenza vaccination (P = 0.006), while age was not (P = 0.441). The primary reason cited for not getting vaccinated was a lack of information about the influenza vaccine (n = 144, 46%). Media sources such as radio, television, and the Internet were the most common sources of vaccine information (n = 89, 40%), while only a small fraction (n = 15, 6.7%) received information from their gynecologist. CONCLUSIONS FOR PRACTICE: Low self-reported vaccination rates among pregnant women in Split-Dalmatia County were primarily due to insufficient awareness and inadequate information from healthcare professionals. Improved education and proactive vaccine promotion by healthcare providers are critical to addressing this gap.
Community-Led Solutions to Address Black Maternal and Infant Mortality Through the TNT-PISP Model: A Qualitative Study.
White MS, Zwaga D, Swan LET … +3 more , Frizell-Thomas B, Oniah O, Zapata JY
Matern Child Health J · 2026 May · PMID 42068524 · Full text
OBJECTIVES: In both the U.S. and Wisconsin, Black women and infants experience significantly higher rates of morbidity and mortality than their white counterparts. Our research team set out to explore how a community-bas...
OBJECTIVES: In both the U.S. and Wisconsin, Black women and infants experience significantly higher rates of morbidity and mortality than their white counterparts. Our research team set out to explore how a community-based and culturally informed perinatal support model could address the needs of Black mothers and their families. METHODS: We developed and implemented the Today Not Tomorrow Pregnancy and Infant Support Program (TNT-PISP), a community-based, culturally informed perinatal support model integrated with traditional obstetrical care. From October 2019 to August 2022, we held monthly support group sessions facilitated by Black community-based doulas, Black physicians, and community partners. Twenty-five participants engaged in topic-focused and freeform sessions to discuss mental health, breastfeeding, peripartum care, and medical racism. Data were collected through semi-structured interviews and focus groups and analyzed using the Daughtering Method and reflexive thematic analysis. RESULTS: Participants emphasized the importance of shared Black identity and culture in fostering connection and trust. The group's open, judgment-free environment allowed for meaningful conversations and emotional support. Participants valued the exchange of parenting knowledge and community resources. The program's flexible structure and child-friendly setting were key strengths, enabling consistent participation despite busy schedules. CONCLUSIONS FOR PRACTICE: This study highlights the potential of community-based, culturally informed perinatal support programs to promote health equity for Black women and infants. Future research should explore such programs' long-term impacts and scalability in diverse settings. Continued efforts to integrate culturally relevant care models into traditional healthcare systems may help promote health inequities in Black communities.
A Spatial Analytic Approach to Maternal Health Following Hurricane Florence (2018).
Lysne K, Sugg M, Reed C … +3 more , Runkle J, Guignet D, Perry LB
Matern Child Health J · 2026 May · PMID 42056388 · Full text
BACKGROUND: The United States leads developed nations in maternal morbidity, yet research on the literature surrounding severe maternal health in the context of natural disasters remains limited. Projections suggest that...
BACKGROUND: The United States leads developed nations in maternal morbidity, yet research on the literature surrounding severe maternal health in the context of natural disasters remains limited. Projections suggest that tropical cyclone (e.g., hurricane, typhoon, cyclone) intensity will continue to surge as global temperatures rise, and experts warn that they pose one of the most significant threats to global public health in the 21st century. OBJECTIVE: This study is the first to apply a spatial clustering approach to maternal health following exposure to a tropical cyclone in North Carolina. METHODS: We conducted an exploratory clustering analysis of hospitalizations for Severe Maternal Morbidity (SMM-21) using the Bernoulli-Kulldorff SaTScan statistic in the context of Hurricane Florence (2018). Multivariate logistic regression identified individual and contextual factors associated with high-risk clusters in the aftermath of Hurricane Florence (2018). RESULTS: All 28 FEMA disaster-declared counties had presence within an SMM spatial cluster, while individual factors (age ≥ 40) and contextual factors (racial segregation [ICE Race], reduced greenspace, and high-urbanity) were associated with residence in high-risk clusters. CONCLUSION: Results indicate the importance of a spatial analytic approach following climate disasters to better identify characteristics of high-burden maternal populations for post-disaster relief and response.
Variations in Eclampsia Risk Across Asian Origin Groups in the United States.
Huang W, Li G, Friedman A … +1 more , Guglielminotti J
Matern Child Health J · 2026 May · PMID 42056387 · Publisher ↗
OBJECTIVES: Eclampsia is a leading contributor of severe maternal morbidity in the United States. Although the rates of severe maternal morbidity for Asian and non-Hispanic White birthing people are similar, variations i...
OBJECTIVES: Eclampsia is a leading contributor of severe maternal morbidity in the United States. Although the rates of severe maternal morbidity for Asian and non-Hispanic White birthing people are similar, variations in eclampsia risk across Asian origin groups have not been adequately studied. METHODS: A cross-sectional study using public access Natality Files data (2018-2021). The exposure was maternal race (non-Hispanic White or Asian), and nativity (foreign- or US-born), with foreign-born non-Hispanic White birthing people defined as the reference group. The outcome was eclampsia. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) of eclampsia associated with race and nativity were estimated using multivariable logistic regression models. RESULTS: Of the 8,295,025 birth certificates analyzed, 21,547 (26.0 per 10,000) recorded eclampsia. The incidence of eclampsia per 10,000 was 14.7 for foreign-born White people, 26.7 for US-born White, 20.9 for foreign-born Asians, and 49.6 for US-born Asians. Among Asian origin groups, the highest incidence of eclampsia per 10,000 was observed among US-born Japanese (256.0), followed by US-born Filipinos (120.6), foreign-born Filipinos (82.9) and US-born Japanese (32.7). After adjustment and compared to foreign-born White people, US-born Filipinos had the highest odds of eclampsia (aOR: 9.36; 95% CI: 7.51, 11.67), followed by foreign-born Filipino (aOR: 6.09; 95% CI: 4.95, 7.50), US-born Japanese (aOR: 4.89; 95% CI: 3.45, 6.92), foreign-born Japanese (aOR: 3.18; 95% CI:2.26, 4.47), and US-born non-Hispanic White (aOR: 2.13; 95% CI: 1.96, 2.32). CONCLUSIONS FOR PRACTICE: Eclampsia risk varies significantly across Asian origin groups and by nativity.
Associations Between Parental Misperceptions of Preschoolers' Weight and Diet- and Physical Activity-Related Parenting Attitudes and Practices.
Cai Z, Wang T, Jiang K … +2 more , Sharma M, Zhao Y
Matern Child Health J · 2026 May · PMID 42029888 · Publisher ↗
OBJECTIVE: Diet- and physical activity-related parenting attitudes and practices play a central role in shaping young children's diet and physical activity behaviors. Accurate parental perception of children's weight is...
OBJECTIVE: Diet- and physical activity-related parenting attitudes and practices play a central role in shaping young children's diet and physical activity behaviors. Accurate parental perception of children's weight is particularly important, as it may influence these parenting attitudes and practices. This study examined the prevalence of parental misperceptions of preschoolers' weight and their associations with diet- and physical activity-related parenting attitudes and practices in China. METHODS: This online cross-sectional study included 17,342 parents of preschoolers in Chongqing, China. Parents reported perception of their child's weight status and diet- and physical activity-related parenting attitudes and practices. Multivariable logistic regression was used to examine the associations between parental weight misperceptions and parenting attitudes and practices. RESULTS: Overall, 26.8% of parents underestimated and 19.2% overestimated their child's weight. Overestimation occurred in 64.3% of underweight children, and underestimation occurred in 87.2% of children with overweight or obesity. In the overall sample, overestimation was associated with lower odds of being in the high-score group for total attitudes (OR 0.92, 95% CI 0.85-0.99) and diet-related attitudes (OR 0.88, 95% CI 0.80-0.97); underestimation was associated with lower odds of being in the high-score group for diet-related attitudes (OR 0.92, 95% CI 0.85-0.99). For parenting practices, overestimation was associated with higher odds of being in the high-score group for total practices (OR 1.21, 95% CI 1.11-1.31) and physical activity-related practices (OR 1.12, 95% CI 1.03-1.22); underestimation was associated with higher odds of being in the high-score group for non-responsive feeding practices (OR 1.13, 95% CI 1.06-1.22). In stratified analyses, the associations varied by children's actual weight status. CONCLUSION: Parental misperceptions of preschoolers' weight were associated with specific diet- and physical activity-related parenting attitudes and practices. These findings may help inform family-based approaches to childhood weight management.
Investigating Sustained Breastfeeding: A Grounded Theory Study.
Meyer HA, Miller EL, Kazimierczuk FK … +2 more , Morrison CF, Ware J
Matern Child Health J · 2026 May · PMID 42012707 · Publisher ↗
OBJECTIVE: Despite the well-documented barriers to breastfeeding and reasons for cessation, a group of resilient women residing in low breastfeeding initiation regions are defying the odds. They continue to breastfeed fo...
OBJECTIVE: Despite the well-documented barriers to breastfeeding and reasons for cessation, a group of resilient women residing in low breastfeeding initiation regions are defying the odds. They continue to breastfeed for longer than six months. This research aimed to identify the common factors and social processes contributing to their longer breastfeeding duration. METHODS: A Grounded Theory study investigated sustained breastfeeding in women who attended a support group in neighborhoods where breastfeeding initiation was low. Breastfeeding women (N = 10) who had provided human milk for more than six months were recruited. In semi-structured interviews, participants responded to questions formulated to understand common factors and social processes for these women. Constant comparative analysis continued until all emerging concepts became saturated. RESULTS: The emergent theoretical framework for sustained breastfeeding is a complex social process comprised of internal and external influences. The individual lens of the breastfeeding person filters perceptions of barriers, hardships, sources of support, and their external environment. The critical social process for sustained breastfeeding among this group of women was personally constructing breastfeeding-supportive environments in which they could thrive. CONCLUSIONS FOR PRACTICE: The findings underscore the importance of establishing individualized breastfeeding-supportive environments early in the breastfeeding journey. This insight can guide lactation professionals in assisting breastfeeding persons in finding the right community to sustain breastfeeding. Open conversations about breastfeeding exposure, social supports, and positive/negative influences on breastfeeding can be instrumental in this process.
Oral Health Literacy Among Pregnant Women in Urban Malaysia: A Cross-Sectional Study.
Alsagoff ZA, Ng CW, Yunus NNN
Matern Child Health J · 2026 May · PMID 42010205 · Publisher ↗
OBJECTIVES: Oral health literacy (OHL) is an important determinant of oral health outcomes. Low parental OHL has been associated with higher rates of dental caries among children. This study examined OHL and factors asso...
OBJECTIVES: Oral health literacy (OHL) is an important determinant of oral health outcomes. Low parental OHL has been associated with higher rates of dental caries among children. This study examined OHL and factors associated with it among pregnant women in an urban area in Malaysia. METHODS: This cross-sectional study included a convenience sample of 455 pregnant women attending antenatal clinics in an urban district near Kuala Lumpur. Self-administered questionnaires collected sociodemographic information. OHL was measured using the validated Malay version of the 14-item Health Literacy in Dentistry Scale (MHeLD-14). HeLD-14 scores were analysed as a continuous variable, and associations between sociodemographic factors and OHL were explored using multivariable linear regression. RESULTS: The mean age of respondents was 29.7 years (SD 4.7). Of the 455 respondents, 439 had complete MHeLD-14 responses, and 418 were included in regression analyses after excluding cases with missing covariate data. The median OHL score was 52 (IQR 46-54.5; range 0–56). Item-level responses indicated greater difficulty with support-related items, such as bringing someone to a dental appointment, compared with utilisation-related items. In exploratory adjusted analyses, tertiary education was significantly associated with higher OHL scores, while Chinese and Indian ethnicity were associated with lower OHL scores compared with Malay respondents. CONCLUSIONS FOR PRACTICE: Respondents reported relatively high oral health literacy (OHL) scores. However, difficulties in support-related tasks suggest that practical and contextual barriers may limit the effective use of oral health services during pregnancy. These findings highlight the need for maternal oral health promotion strategies that go beyond information provision and address logistical and social barriers within antenatal care settings.
Autistic Adolescents' and their Parents' Perspectives on a National Flourishing Item Set: A Construct Validation Study.
Ross-Cypcar SM, Zimmerman S, Frame L … +4 more , Williams T, Pickett A, Haegele JA, Anderson K
Matern Child Health J · 2026 Apr · PMID 41989537 · Publisher ↗
PURPOSE: Flourishing, or positive mental well-being, may be represented by social relationships, school motivation, and behavioral skills for engaging in meaningful activities. Parents of autistic adolescents demonstrate...
PURPOSE: Flourishing, or positive mental well-being, may be represented by social relationships, school motivation, and behavioral skills for engaging in meaningful activities. Parents of autistic adolescents demonstrate different response patterns to flourishing items on the National Survey of Children’s Health (NSCH) when compared to parents of non-autistic adolescents. To better understand the source of these differences, we examined the clarity and construct relevance of flourishing items for autistic adolescents (12–17 years). METHODS: Sixteen adolescents (Mean age = 14.6 years) and their parents participated in cognitive interviews, where they were prompted to discuss aloud how they interpreted each item and selected a response option. Parent responses were scored relative to their child’s response for direction (more or less favorable) and magnitude (distance between responses). A deductive thematic analysis was undertaken to identify sources of confusion and the perceived relevance of items to participants. RESULTS: Overall, 39% of dyad responses aligned, while 34% of parents’ responses were less favorable than their child’s self-rated score. Participants showed evidence of confusion around word choice for homework, arguing too much, and challenged normative language in homework and friendships questions. Participants recommended alternative response options that would better reflect their experiences of flourishing. CONCLUSION: Autistic adolescents and their parents generally viewed the NSCH flourishing domains as relevant to adolescent well-being, while differing in how specific items were interpreted and applied. These findings highlight the importance of considering response interpretation when using flourishing indicators in population surveillance and subgroup comparisons involving autistic adolescents.
20 Years of Impact on the MCH Workforce: The Tulane Center of Excellence in Maternal and Child Health.
Mantsios A, Ramirez SM, Frazier JE … +2 more , Theall KP, Bazzano AN
Matern Child Health J · 2026 Apr · PMID 41986783 · Publisher ↗
PURPOSE: The Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB) provides funding to support Centers of Excellence (CoE) to prepare the next generation of Maternal and Child Heal...
PURPOSE: The Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB) provides funding to support Centers of Excellence (CoE) to prepare the next generation of Maternal and Child Health (MCH) leaders through specialized training and mentorship. This study describes the impact of Tulane University's workforce development program in MCH. DESCRIPTION: We utilized a holistic evaluation approach to examine the impact of Tulane University's CoE, from the program's inception in 2000 through 2024, in building the MCH workforce. ASSESSMENT: Utilizing a retrospective evaluation design, routinely collected quantitative and qualitative enrollment and follow-up survey data from program alumni were analyzed. Data reveal the following: (1) the program has trained a broad group of MCH professionals from a wide range of backgrounds, strengthening a workforce prepared to respond to needs of varied communities, (2) alumni overwhelmingly continue to work in MCH after graduation, frequently serving populations with significant unmet health needs and in collaboration with Title V (MCH) agencies, and (3) the majority of trainees go on to serve in leadership positions in policy, practice, academia, or clinical settings. CONCLUSIONS: A well-trained MCH workforce is contingent upon high-quality education and preparation for leadership roles. Through funding from HRSA's MCH Workforce Development Division, Tulane University's CoE has trained people from varied backgrounds, including from populations not well represented in health sciences and communities disproportionately affected by adverse health outcomes, to assume leadership roles and contribute substantively to the field. These results can inform MCH training programs to further strengthen their impact on developing the MCH workforce.
The Association Between Shared Decision-Making and Child Health in the General Pediatric Population.
Cohen A, Michelson KN, Macy ML … +2 more , Heard-Garris N, Kan K
Matern Child Health J · 2026 Apr · PMID 41986782 · Full text
OBJECTIVE: Shared decision-making (SDM) is a decision-making approach that aims to enhance collaboration between patients and providers. SDM is associated with improved health outcomes and decreased healthcare expenditur...
OBJECTIVE: Shared decision-making (SDM) is a decision-making approach that aims to enhance collaboration between patients and providers. SDM is associated with improved health outcomes and decreased healthcare expenditure among children with special health care needs. However, much remains unknown about the role of SDM in the broader general pediatric population. We sought to describe associations between SDM and child health and healthcare utilization in a national pediatric sample. METHODS: Using data from the 2019-2021 National Survey of Children's Health, we examined the association between SDM and forgone health care, missed school days due to illness or injury, and emergency department (ED) visits. Bivariate and multivariable logistic regression analyses were performed and adjusted for sociodemographic variables. RESULTS: The study sample included 31,791 children who needed medical decisions made in the prior 12 months (mean age 8.7 years, 42.3% with special health care needs). Most (85%) experienced SDM. In adjusted analysis, SDM was associated with significantly lower odds of children forgoing needed health care (adjusted odds ratio [aOR] = 0.22, 95% confidence interval [CI] 0.17-0.27), and lower odds of > 4 missed school days (aOR = 0.80, 95% CI 0.66-0.95). Experiencing SDM was not associated with ED visits. CONCLUSIONS FOR PRACTICE: SDM may confer benefits for all children in a general pediatric population. Experiencing SDM was associated with less forgone health care and fewer missed school days due to illness or injury. Future work should explore approaches to SDM that consider the needs and preferences of families across the spectrum of pediatric care.
Correlates of Maternal Depressive Symptomatology Among Latina Head Start Mothers.
Palmer Molina A, Premo EM, Duan L … +1 more , Mennen FE
Matern Child Health J · 2026 Apr · PMID 41961176 · Full text
OBJECTIVES: Low-income, Latina mothers are at high risk for experiencing maternal depression, which can impact their young children. This study sought to identify socioeconomic, psychosocial, health, and cultural correla...
OBJECTIVES: Low-income, Latina mothers are at high risk for experiencing maternal depression, which can impact their young children. This study sought to identify socioeconomic, psychosocial, health, and cultural correlates of depressive symptoms among Latina mothers of Head Start children. METHODS: A cross-sectional study was conducted with baseline data from 163 Latina mothers enrolled in a larger intervention trial (Mage = 32.7, SD=6.3). Mothers were screened for depressive symptoms using the Center for Epidemiology Studies Depression Scale (CES-D). Hierarchical regression models examined whether socioeconomic factors (education, employment, insurance status, income, economic pressure, and number of children in household), psychosocial and health factors (age, lifetime trauma exposure, intimate partner violence (IPV) exposure, living situation, health problems, social support, and prior mental health history), and cultural factors (maternal nativity, preferred language) explained a statistically significant amount of variance in maternal depressive symptoms. RESULTS: 38% of Latina Head Start mothers reported clinically significant levels of depressive symptomatology. Reporting income from earnings and social support were negatively associated with depressive symptoms, whereas lifetime trauma exposure, exposure to current physical and verbal IPV, and endorsing a history of depression were positively associated with depressive symptoms. Cultural factors were not significant. CONCLUSIONS FOR PRACTICE: Findings indicate a high rate of elevated depressive symptomatology in this sample. Cross-system interventions are needed that address both structural and psychosocial contributors to maternal depression for low-income, Latina mothers of young children. Future research should continue to explore the role of cultural factors for Latina mothers.
Clinical Outcomes of a Tech-enabled Perinatal Collaborative Care Program to Treat Depression and Anxiety.
Steele K, Zimmermann M, Simas TAM … +5 more , Byatt N, Koli R, Sherman M, Gaulton J, McNutt C
Matern Child Health J · 2026 Apr · PMID 41954856 · Full text
OBJECTIVE: To evaluate a tech-enabled collaborative care program in an obstetrics and gynecology (OB/GYN) practice for the treatment of perinatal depression and anxiety symptoms. METHODS: We conducted a retrospective coh...
OBJECTIVE: To evaluate a tech-enabled collaborative care program in an obstetrics and gynecology (OB/GYN) practice for the treatment of perinatal depression and anxiety symptoms. METHODS: We conducted a retrospective cohort chart review from the electronic medical records of N = 185 patients enrolled in a pilot perinatal collaborative care program delivered by a behavioral health company, Family Well Health, in partnership with a large OB/GYN practice in Massachusetes (USA). FamilyWell’s collaborative care model (CoCM) provides telehealth sessions with a certified perinatal behavioral health coach or a licensed therapist, medication management, and implementation assistance to enhance depression screening, assessment, and treatment of perinatal mood and anxiety disorders (PMADs). English-speaking adults aged ≥ 18 years who screened positive for depression (Edinburgh Postnatal Depression Scale [EPDS] score ≥ 10) by their OB/GYN clinician were referred to the FamilyWell program. Enrolled patients received weekly or biweekly telehealth sessions with a certified coach or licensed therapist and completed monthly electronic symptom assessments for anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]) and depression (Patient Health Questionnaire 9-item scale [PHQ-9]). Assessment scores were monitored by a behavioral care manager. We evaluated three clinical outcomes including change in GAD-7 and PHQ-9 scores, treatment response (50% or greater decrease in GAD-7 or PHQ-9 scores), and symptom remission (follow-up PHQ-9 or GAD-7 score < 5). RESULTS: Over 80% of referred patients enrolled in CoCM and more than 70% completed their intake session within one week. At baseline, 86% had a positive GAD-7 or PHQ-9 score (GAD-7 or PHQ-9 ≥ 10 indicating symptoms of moderate, moderate-severe, or severe depression or anxiety). Patients received services from a certified coach (77%) or therapist (23%). PHQ-9 scores decreased by 1.3 points per month (95% CI [− 1.5, − 1.2], p < .001) and GAD-7 scores decreased by 1.3 points per month (95% CI [− 1.5, − 1.2], p < .001). Forty-seven percent of patients (n = 33) demonstrated depression treatment response and 52% (n = 45) demonstrated anxiety treatment response. In addition, 30% of patients (n = 26) experienced anxiety symptom remission in a mean time of 3.2 months and 31% (n = 22) experienced depression symptom remission in a mean time of 3.5 months. Patients received a mean of 8 sessions with a therapist and 9 sessions with a coach before experiencing symptom remission. CONCLUSION: These data suggest that implementing a tech-enabled, coach-driven perinatal collaborative care program is associated with decreases in depression and anxiety symptoms. Symptom remission occurred within eight sessions with a therapist or nine sessions with a coach. Unlike other psychiatric collaborative care programs described in the literature, this program uniquely addresses the behavioral health workforce shortages by integrating certified coaches as a primary intervention and utilizing telehealth- and text-based support to enable scale. Our results suggest that this integrated behavioral health approach can be implemented outside the research setting.
Association Between Air Pollutant Exposure and Preterm Birth: A Retrospective Cohort Study.
Cao Z, Du Y, Sun L … +4 more , Fan Z, Idowu AL, Zhang F, Zhang Y
Matern Child Health J · 2026 Apr · PMID 41954855 · Publisher ↗
OBJECTIVES: To explore the relationship between air pollutant exposure and preterm birth. DESIGN: It was a retrospective cohort study. METHODS: We conducted a retrospective cohort study of 48,534 singleton pregnancies de...
OBJECTIVES: To explore the relationship between air pollutant exposure and preterm birth. DESIGN: It was a retrospective cohort study. METHODS: We conducted a retrospective cohort study of 48,534 singleton pregnancies delivered at Nantong Maternal and Child Healthcare Hospital between January 1, 2017 and December 31, 2022. Daily concentrations of six pollutants (PM2.5, PM10, SO2, NO2, CO, O3) were assigned to each woman’s residence and averaged over the first (T1), second (T2), and third (T3) trimesters. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for PTB across pollutant quartiles, adjusting for maternal age, parity, season of last menstrual period, fetal sex, pregnancy complications, heart disease, uterine fibroids, obesity, and precious infant status. Generalized estimating equations (GEE) accounted for within-subject exposure correlations. Sensitivity analyses compared models with and without adjustment for pregnancy complications. RESULTS: In fully adjusted Cox models, highest-quartile exposure to PM2.5 during T1 and T3 was associated with increased PTB risk (T1 Q4 vs. Q1: HR=1.155, 95% CI: 1.025–1.302; T3 Q4 vs. Q1: HR=1.325, 95% CI: 1.182–1.486). SO2, NO2, and O3 exposures in T3 similarly elevated PTB risk (SO2 Q4 vs. Q1: HR=1.750, 95% CI: 1.570–1.951; NO₂ Q4 vs. Q1: HR=1.311, 95% CI: 1.154–1.489; O₃ Q4 vs. Q1: HR=1.466, 95% CI: 1.282–1.677). GEE analyses corroborated these associations (all p<0.001). Sensitivity analyses yielded consistent estimates, indicating negligible mediation by pregnancy complications. CONCLUSIONS: Late-pregnancy exposure to pollutants confers the risk for preterm birth. Public health interventions should prioritize air quality improvement during the third trimester to reduce PTB incidence.
Malnutrition in Children with Congenital Zika Virus Syndrome: A Systematic Review.
da Silva DS, Dos Santos LKC, Barbosa SS … +4 more , Costa ÁDS, Arrais NMR, Ribeiro KDDS, Lopes MMGD
Matern Child Health J · 2026 Apr · PMID 41954854 · Full text
OBJECTIVE: We examined previous studies to describe growth deviations in children with Congenital Zika virus Syndrome (CZS), and to determine the factors associated with malnutrition. STUDY DESIGN: Protocol of systematic...
OBJECTIVE: We examined previous studies to describe growth deviations in children with Congenital Zika virus Syndrome (CZS), and to determine the factors associated with malnutrition. STUDY DESIGN: Protocol of systematic review registered on the PROSPERO platform under code CRD42023460505. The searches were conducted in SciELO, LILACS, Embase, Scopus, and PubMed/MEDLINE databases, as well as in dissertation and thesis repositories. The eligibility criteria required that the publications must be observational, cross-sectional, cohort, or case-control studies conducted with children with microcephaly associated with CZS, which presented results (z-score) of anthropometric indices of weight-for-age, height-for-age, weight-for-height, and/or body mass index (BMI)-for-age; written in English, Portuguese, or Spanish; and published between 2010 and 2023. The z-score values from anthropometric indices and the factors associated with malnutrition (wasting, underweight, overweight, or stunting) were extracted. RESULTS: Eleven studies met our inclusion criteria. In these studies, children's ages ranged from 0 to 48 months. Malnutrition was identified as stunting (14.3% to 57.1%), underweight (14.3% to 54.4%), wasting (4.3% to 48.0%), and, to a lesser extent, as overweight (4.6% to 68.6%). The association of these indices was examined in relation to dysphagia, absence or duration of breastfeeding, delayed introduction of complementary feeding, consumption of ultra-processed foods, and feeding route. CONCLUSION: It was possible to identify short stature, wasting, excess weight, and inappropriate eating practices in children with CZS.
Prenatal Mental Health Screening and Support in a Multidisciplinary Fetal Imaging Program: a Brief Report on Protocol and Early Findings.
Bartolini E, Vozar TM, Plessis AD … +2 more , Andescavage N, Limperopoulos C
Matern Child Health J · 2026 Apr · PMID 41944962 · Publisher ↗
PURPOSE: In this brief report, we present an overview of an integrated mental health program for pregnant patients undergoing subspecialty evaluation for suspected fetal anomaly at Children’s National Hospital. Our appro...
PURPOSE: In this brief report, we present an overview of an integrated mental health program for pregnant patients undergoing subspecialty evaluation for suspected fetal anomaly at Children’s National Hospital. Our approach begins with universal mental health screening administered prior to fetal imaging appointments, with specialized therapy services made available for patients identified as elevated risk for poor mental health outcomes. This study aims to describe the mental health of our patients and to identify risk and protective factors influencing their mental health. The relevant literature, approach, and protocol are highlighted, along with initial findings from a single year of universal screening. METHODS: From June 2023 to June 2024, 661 patients completed mental health screening measures, including the Edinburgh Postnatal Depression Scale (EPDS) and measures of pregnancy-related worry, health literacy, guilt/self-blame, social support, and self-reported resilience. RESULTS: Among 661 participants, 33% scored in the elevated range for depression, while 57% reported high levels of worry, suggesting significant distress in this population. Attendance rates and patient satisfaction at follow-up care were high (93.6% and 100%, respectively), suggesting high treatment acceptability and effectiveness. CONCLUSION: Our findings underscore the critical need for integrated mental health services in prenatal settings, revealing clinically significant distress among patients and highlighting modifiable factors that could inform tailored interventions.
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