Matern Child Health J [JOURNAL]
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200 papers
Impact of COVID-19 Infection Rates on Pregnancy Outcomes and Disparities in Florida.
Bernet P, Onal SO
Matern Child Health J · 2025 Dec · PMID 41148553 · Full text
OBJECTIVES: This study investigated whether county COVID-19 infection rates during the first trimester were associated with adverse pregnancy outcomes and whether those disproportionately impacted Black or Hispanic women...
OBJECTIVES: This study investigated whether county COVID-19 infection rates during the first trimester were associated with adverse pregnancy outcomes and whether those disproportionately impacted Black or Hispanic women. METHODS: This study used birth outcomes data 2018 through 2022 for four of Florida's five largest counties. Outcomes were paired with census tract socioeconomic characteristics and with COVID-19 infection rates during the first trimester in the woman's home county. Outcome measures included preterm birth, low birthweight and very low birthweight. Multivariate regression was used to test the association between infection rates and all outcomes. Then, a difference-in-difference approach was used to assess the impact of infection rates on racial and ethnic outcome disparities. RESULTS: County infection rates during the first trimester were significantly associated with worse pregnancy outcomes for all women. Each 1% point increase in COVID-19 cases during the first trimester was associated with a 5.16% point increase in the probability of preterm birth, a 4.35% point increase in the probability of low birth weight, and a 2.59% point increase in the probability of very low birth weight. Compared to White women, each 1% point increase in cases of COVID-19 during the first trimester caused a 1.21% point increase in the probability of preterm births, a 1.57% point increase in the probability of low birthweight, and a 1.28% point increase in the probability of very low birthweight among Black women. While no significant differences were observed in the probabilities of preterm birth and low birthweight between White and Hispanic women, the result revealed that each 1% point increase in cases of COVID-19 during the first trimester caused a 0.23% point increase in the probability of very low birthweight among Hispanic women compared to White women. CONCLUSIONS FOR PRACTICE: This study found evidence that local COVID-19 infection rates during the first trimester are associated with worse pregnancy outcomes. Moreover, the findings indicate that local COVID-19 infection rates during the first trimester exacerbate racial disparities in these outcomes.
Mid-Trimester Allostatic Load and Spontaneous Preterm Birth in a Cohort of Pregnant Women Living with HIV in Zambia.
Rittenhouse KJ, Vwalika B, Sebastião YV … +7 more , Resop RS, Mwape H, De Paris K, Lubeya MK, Kasaro MP, Stringer JSA, Price JT
Matern Child Health J · 2025 Dec · PMID 41134424 · Full text
OBJECTIVES: Maternal HIV is associated with preterm birth (PTB). In resource-rich settings, spontaneous preterm birth (SPTB) has been linked to biomarkers of stress. We examined the association between allostatic load an...
OBJECTIVES: Maternal HIV is associated with preterm birth (PTB). In resource-rich settings, spontaneous preterm birth (SPTB) has been linked to biomarkers of stress. We examined the association between allostatic load and SPTB among women with HIV. METHODS: In a nested case-cohort analysis of a randomized trial of intramuscular progesterone to prevent PTB in women with HIV in Lusaka, Zambia, we measured 15 midtrimester plasma biomarkers from 4 domains: cardiovascular, immune, metabolic, and neuroendocrine. SPTB was defined as delivery <37wks preceded by spontaneous labor or membrane rupture. A composite ALI was calculated by summing Z-scores from all markers (ALI-15); another was calculated from a 7 marker subset (ALI-7) with Z-score differences >0.1 between outcome groups. We estimated SPTB time-to-event curves and hazard ratios (HR) between ALI quartiles. RESULTS: Of 800 women enrolled in IPOP (2015-2017), 51 (6%) had SPTB. We randomly selected 107 participants, including 6 with SPTB (cases). We then selected all remaining cases (n=45), yielding a final sample of 152. Z-score distributions of systolic blood pressure, heart rate, HDL, triglycerides, hemoglobin A1C, albumin, and 25-OH Vitamin D were included in ALI-7. Participants in the fourth quartile of ALI-7 were more likely to experience SPTB (HR 2.49, 95% CI 1.15-5.40) than participants in the second quartile; this association was attenuated when quartile groups were defined by ALI-15 (HR 1.24, 95% CI 0.59-2.60). CONCLUSIONS: High ALI among women with HIV was associated with SPTB. A seven marker ALI appeared a more meaningful indicator of risk than one composed of all measured markers.
Community-Based Approaches to Developing a Community-Level Intervention to Improve Black Maternal and Infant Health.
Omowale SS, Cottrell-Daniels C, Miller K … +6 more , Jones L, Jones T, Chand M, McGhee B, Slatton B, Kuppermann M
Matern Child Health J · 2025 Dec · PMID 41107701 · Publisher ↗
PURPOSE: Persistent racial inequities and inadequate healthcare for Black women during childbirth and postpartum have led to disturbing maternal and infant mortality disparities in the United States. The purpose of the c...
PURPOSE: Persistent racial inequities and inadequate healthcare for Black women during childbirth and postpartum have led to disturbing maternal and infant mortality disparities in the United States. The purpose of the current manuscript is to describe community-based approaches to inform the development of a maternal and child health intervention. DESCRIPTION: To address these health disparities, a community-based research team was formed to develop a population-specific community-level intervention that pairs social workers and doulas to improve Black maternal and infant health. ASSESSMENT: A community-based research team was established with a birth doula, a clinical social worker, a Black mother, community research scientists, and a community research assistant from the San Francisco Bay Area, California. Moreover, the team members brought their lived experiences and professional expertise, which informed our research approach. The community team members were integral in developing research protocols and approaches. We leveraged university infrastructure, trained team members in research methods, and compensated team members for their expertise. CONCLUSION: This ongoing community-based research approach will build long-term capacity and engagement to develop a community-level population-specific intervention to improve Black maternal and infant health outcomes.
Patterns of Non-fatal Overdose and Injection-Related Bacterial Infections During Pregnancy and the Postpartum Year Among New York State Residents.
Cooper HLF, D'Souza RR, Chang HH … +5 more , Peterson E, Rogers E, Wien S, Blake SC, Kramer MR
Matern Child Health J · 2025 Dec · PMID 41085880 · Full text
OBJECTIVES: Overdoses are a leading cause of maternal mortality in the US, but limited evidence exists about patterns of nonfatal overdose, a key risk factor for subsequent fatal overdose, or of other drug-related harms....
OBJECTIVES: Overdoses are a leading cause of maternal mortality in the US, but limited evidence exists about patterns of nonfatal overdose, a key risk factor for subsequent fatal overdose, or of other drug-related harms. Here, we estimate prevalences of nonfatal overdose and injection-related endocarditis and abscesses/cellulitis across the 21 months spanning pregnancy and the postpartum year. METHODS: Among people who experienced an in-hospital birth in New York State between 9/1/2016 and 1/1/2018 (N = 330,872), we estimated the prevalences of hospital-based diagnoses of nonfatal overdose and of injection-related bacterial infections (i.e., endocarditis, abscesses, and cellulitis) across these 21 months; by trimester and postpartum quarter; and by social position (e.g., race/ethnicity, rurality, payor). RESULTS: The 21-month nonfatal overdose prevalence was 158/100,000 births (CI: 145/100,000, 172/100,000); the 21-month prevalence of injection-related bacterial infections was 56/100,000 births (CI: 49/100,000, 65/100,000). There was a trend such that rates of overdose and of injection-related bacterial infections declined as pregnancy progressed and rebounded postpartum. Rates of all outcomes were highest outside of large metropolitan areas and among publicly insured residents. CONCLUSIONS FOR PRACTICE: The trend toward diminished rates during pregnancy is supported by past qualitative studies. If confirmed by future research in other geographical regions and with larger sample sizes, this finding holds promise for programmatic and policy interventions. Interventions co-designed with people who use drugs could complement and support harm reduction efforts that pregnant people are already engaging in independently. Such efforts can help people who use drugs survive the pregnancy and postpartum year.
Development and Psychometric Properties of the Diarrhea Management Scale for Mothers (DiMaM).
Aközlü Z, Göbekli A, Yıldız S
Matern Child Health J · 2025 Nov · PMID 41071426 · Publisher ↗
OBJECTIVE: This study aimed to develop and evaluate the psychometric properties of a diarrhea management scale for mothers with children aged 0-24 months. METHODS: This methodological study was conducted between February...
OBJECTIVE: This study aimed to develop and evaluate the psychometric properties of a diarrhea management scale for mothers with children aged 0-24 months. METHODS: This methodological study was conducted between February and June 2023 with 449 mothers in the pediatric emergency department of a training and research hospital in Istanbul. Data were collected using a sociodemographic data form and the Diarrhea Management Scale for Mothers (DiMaM). The scale's validity and reliability were analyzed using the Kaiser-Meyer-Olkin coefficient, Bartlett's Test of Sphericity, Cronbach's alpha reliability coefficient, fit indices, independent samples t-test, test-retest analysis, mean item scores of the 27% lower and upper groups, and item-total correlation statistics. RESULTS: Factor analysis revealed five factors explaining 71.466% of the total variance. The Cronbach's alpha coefficient was 0.887 for the overall scale, 0.913 for the intestinal and stool monitoring subscale, 0.762 for the symptom monitoring subscale, 0.735 for the therapeutic interventions subscale, 0.683 for the hygiene and responsibility subscale, and 0.743 for the nutrition and fluid supplementation subscale. Confirmatory factor analysis indicated acceptable fit indices for the scale. Standardized factor loadings ranged from 0.549 to 0.930, and Intraclass Correlation Coefficient values ranged from 0.886 to 0.916. CONCLUSIONS FOR PRACTICE: DiMaM was determined to be a valid and reliable tool for assessing diarrhea management in the home environment for mothers with children aged 0-24 months.
Variations in Screening Practices for Congenital Cytomegalovirus Infections Among Birthing Hospitals in the United States.
Khaki S, Binder E, Cicco R … +6 more , Hand I, Hecht J, Iwamoto L, Kessel J, Vohr B, Sekhar D
Matern Child Health J · 2025 Nov · PMID 41060607 · Publisher ↗
OBJECTIVE: Evaluate screening practices for congenital cytomegalovirus (cCMV), the most common infectious cause of childhood deafness, in American birthing hospitals. STUDY DESIGN: A survey was developed and distributed...
OBJECTIVE: Evaluate screening practices for congenital cytomegalovirus (cCMV), the most common infectious cause of childhood deafness, in American birthing hospitals. STUDY DESIGN: A survey was developed and distributed to hospitals across the US including the Northeast, Midwest, West, and Southwest between November-December 2023 to understand cCMV screening practices. Summary data were calculated. Hospital characteristics associated with screening were analyzed using a logistic regression model. Hospital practice was reported as a function of legislative mandate. RESULTS: 134 responses were received (28.5% response rate). 78 respondents (58.2%) indicated their hospital screens for cCMV. Common screening indications were newborn hearing screen referral (67.5%) and symptoms that could be attributed to cCMV (57.1%). Odds ratio of cCMV screening for states with screening legislation versus without was 18.0 (p < 0.001). Odds ratio of cCMV screening for urban, level 3 facilities versus rural, level 1 facilities was 6.7 (p < 0.02). CONCLUSION: Wide variability exists in cCMV screening practices. Legislative screening mandates are associated with higher screening rates. Opportunity exists for development of screening guidelines for newborns at risk for cCMV infection.
Prevalence and Co-occurring Developmental, Neurological, and Mental Health Conditions of Cerebral Palsy Among Children in the United States: 2016-2021.
Tian LH, Tinker SC, Russell LA … +6 more , Joncas-Schronce L, Danielson ML, Ivey-Stephenson AZ, Summers AD, Yeargin-Allsopp M, Maenner MJ
Matern Child Health J · 2025 Nov · PMID 41051646 · Full text
INTRODUCTION: Monitoring cerebral palsy (CP) prevalence and co-occurring conditions is crucial for planning lifelong support, but recent national estimates are somewhat limited. METHODS: We analyzed data on U.S. children...
INTRODUCTION: Monitoring cerebral palsy (CP) prevalence and co-occurring conditions is crucial for planning lifelong support, but recent national estimates are somewhat limited. METHODS: We analyzed data on U.S. children aged 2-17 years from the 2016-2021 National Survey of Children's Health, conducted annually using a cross-sectional design, to calculate nationally representative prevalence estimates of ever-diagnosed CP, overall and by selected demographic and perinatal characteristics. Three-year estimates were compared to evaluate changes over time. Co-occurring conditions were assessed among children aged 3-17 years with a current CP diagnosis. We estimated prevalence ratios (PR) to quantify differences between groups. RESULTS: The overall prevalence of CP was 3.1 per 1,000 children, with a higher prevalence among boys (3.6/1,000) than girls (2.5/1,000) and children born with low and very low birthweight (46.6 and 7.1/1,000, respectively) and premature (12.7/1,000); differences by race/ethnicity did not reach statistical significance (non-Hispanic [NH] White: 2.9, NH Black: 4.2, and NH other: 4.5/1,000. There were no clear changes in CP prevalence over time, but caregiver-rated severe CP increased from 16.8% (2016-2018) to 30.3% (2019-2021). Most children with CP had at least one co-occurring condition, about four times more prevalent than in children without CP, with the largest differences for intellectual disability (PR = 43) and epilepsy or seizure disorder (PR = 69). DISCUSSION: There is a significantly higher prevalence of co-occurring developmental, neurological, and mental health conditions among children with CP compared to those without, highlighting the diverse services and resources that may be needed to optimally support this population as they transition into adulthood.
The Impact of a Transition to Motherhood Program on Postpartum Outcomes of Primiparous Women: A Randomized Controlled Trial.
Çelik Eren D, Aydin Avci İ
Matern Child Health J · 2025 Nov · PMID 40996490 · Publisher ↗
OBJECTIVES: Pregnant women who have no experience in the transition to motherhood may face various problems such as low self-evaluation, physically problems, low maternal attachment both in the prenatal and postpartum pe...
OBJECTIVES: Pregnant women who have no experience in the transition to motherhood may face various problems such as low self-evaluation, physically problems, low maternal attachment both in the prenatal and postpartum period. METHODS: This research was conducted as a randomized, controlled, single-blind pretest-post-test experimental study, was performed with primiparous women registered 73 pregnant meeting the inclusion criteria between December 2019 and December 2021. Pretest was applied to the experimental and control groups, Transition to Motherhood program based on Meleis' Transition Theory was applied to the experimental group; two post-tests were applied to the experimental and control groups group at the postpartum sixth week and fourth month. RESULTS: The mean age of the experimental group was 26.91 ± 3.10, 45.7% of them had university or higher education level, 77.1% of them had a planned pregnancy, 88.6% of them had fear of birth. There was no statistically significant difference in terms of characteristic features between the experimental and control groups (p < 0.05). There was no statistically significant difference between the total mean scores of Prenatal Self-Evaluation Questionnaire and Prenatal Attachment Inventory applied as pretest of the pregnant women in the experimental and control groups (p > 0.05). A statistically significant difference was found between the groups; in terms of the Postpartum Self-Assessment Scale, Postpartum Physical Symptoms Severity, and the Maternal Attachment Inventory scores which were applied as the first post-test (postpartum sixth week), and the scores of the Maternal Attachment Inventory applied as the second posttest (postpartum fourth month) (p < 0.05). CONCLUSION: The Transition to Motherhood program had positive effects on postpartum self-assessment, postpartum physical symptom severity and maternal attachment of the primiparas. CLINICAL TRIAL REGISTRATION: This report was prepared in line with the Consort and TIDieR guideline. The research was also registered with Clinical Trials under no. NCT05272527.
Maternity Care Deserts: An Urgent Public Health Problem in Need of Financial Solutions.
Bartick M, Payton C, Jegier B
Matern Child Health J · 2025 Nov · PMID 40991113 · Publisher ↗
More than 80% of US maternal deaths are preventable yet maternity care in the United States (US) is becoming increasingly difficult to access. Recent years have seen the rise of maternity care deserts, defined as an area...
More than 80% of US maternal deaths are preventable yet maternity care in the United States (US) is becoming increasingly difficult to access. Recent years have seen the rise of maternity care deserts, defined as an area with no hospitals or birth centers offering obstetric care and without any obstetric providers. The number of counties without a birthing facility continues to grow, and 1/3 of US counties lack an obstetric clinician. The US has a maternal mortality rate that is 2-3 times greater than similar high-income countries, a steady rise in severe maternal morbidity, and markedly high infant mortality rates compared to similar countries. Traveling long distances to obtain obstetric care can impact whether a woman and infant survive an obstetric emergency such as hemorrhage. Nearly 2/3 of maternity care deserts are in rural areas, with the greatest need for maternity care located in the southern US. Maternity care deserts disproportionately impact rural, low-income, and Black women. The reasons for maternity closures are multifactorial, but are driven by hospital financial pressures and staff shortages. Government interventions are necessary to expand access to care and to keep critical obstetric units open. These interventions include increasing Medicaid reimbursements, expanding Medicaid access, expanding the perinatal workforce, setting standards for what constitutes safe distances between maternity units, and exploring mechanisms to leverage/reimagine existing programs to keep units open in critical areas. We call for urgent action given the serious public health threat to women and infants. We draw from diverse sources not commonly cited to comprehensively summarize the issues related to obstetric closures, outline the drawbacks of many previously proposed solutions, and propose some novel solutions.
Enhancing Equity in Access and Quality of Youth Out-of-School-Time Recreational Activities: Perspectives from Primary Caregivers and Parents in Under-resourced Urban Communities Using Semi-structured Interviews.
La Charite J, Santoro M, Flores C … +4 more , Hurtado A, Lum M, Castellon-Lopez Y, Dudovitz R
Matern Child Health J · 2025 Nov · PMID 40991112 · Full text
OBJECTIVES: Out-of-school-time recreational activities are linked to numerous socioemotional, health, and academic benefits for children. Racial and income disparities in participation persist, yet there is a lack of qua...
OBJECTIVES: Out-of-school-time recreational activities are linked to numerous socioemotional, health, and academic benefits for children. Racial and income disparities in participation persist, yet there is a lack of qualitative studies eliciting the experiences and input of primary caregivers to improve equitable access to high-quality recreational activities in marginalized communities. This study explores caregiver perceptions of the factors influencing motivations to enroll their child in activities, barriers to participation, how caregivers define quality programming, and caregiver recommendations to improve activity access and quality within under-resourced communities. METHODS: We recruited primary caregivers of children aged 6-17 from under-resourced communities in an urban county by purposive sampling through urban parks and recreation and community organizations. We conducted semi-structured interviews using descriptive methodology with content thematic analysis. RESULTS: Thirty-four interviews (17 English, 17 Spanish) revealed three key themes: primary caregivers (1) were highly motivated, believing that activities were facilitators of lifelong healthy living and wellbeing for children, families, and communities, (2) identified ongoing participation barriers while recognizing opportunities to improve equitable access, (3) described high-quality activities as those promoting safety, inclusivity, and enjoyment. Parents highlighted strategies to promote equitable, high-quality programming, including broad outreach, easy enrollment with accessible activities, low financial barriers, structural investments, staff and volunteer training, and family engagement. CONCLUSIONS FOR PRACTICE: Organizations offering youth out-of-school-time activities should consider caregiver practical suggestions to potentially improve the uptake and equity of these programs, with the ultimate goal of supporting the well-being and healthy development of all children.
Disparities in Prenatal Care Utilization in the United States.
McElfish PA, Caldwell AR, Selig JP … +9 more , Watson D, Langner J, Callaghan-Koru J, Porter A, Willis DE, Andersen JA, Hawley NL, Mendoza-Kabua P, Brown CC
Matern Child Health J · 2025 Dec · PMID 40986172 · Full text
OBJECTIVES: This study examined disparities in prenatal care utilization by race/ethnicity and payer using three measures of inadequate prenatal care: (1) fewer than the recommended number of prenatal care visits, (2) la...
OBJECTIVES: This study examined disparities in prenatal care utilization by race/ethnicity and payer using three measures of inadequate prenatal care: (1) fewer than the recommended number of prenatal care visits, (2) late initiation of prenatal care (at or after 4 months gestation), or (3) no prenatal care. METHODS: Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in all 50 U.S. states and the District of Columbia between January 1, 2014, and December 31, 2022 (N = 33,107,382). RESULTS: The average number of reported prenatal care visits was 11.2 (SD = 1.2), 36.8% reported fewer than the recommended number of prenatal care visits, 22.7% reported late initiation of prenatal care, and 1.8% reported no prenatal care. Women with a Medicaid-covered delivery were 1.06 times more likely to have fewer than the recommended number of visits, 1.36 times more likely to initiate prenatal care late, and 1.72 times more likely to have no prenatal visits (all p < 0.001). There were significant disparities in prenatal care utilization by race/ethnicity, particularly for NHPI and AIAN women, with all minoritized racial/ethnic groups having greater risk for multiple measures of inadequate prenatal care utilization relative to White populations. CONCLUSIONS FOR PRACTICE: Racial/ethnic and economic disparities in perinatal health in the U.S. are of national concern. Differences in prenatal care utilization between women with Medicaid and private/other insurance suggest modifications to Medicaid policies may improve prenatal care access among beneficiaries.
African-American Women's Early-Life Exposure to Neighborhood Mortgage Discrimination and Preterm Birth Rates: A Population-Based Study.
Kim C, Cavé Doi SJ, Lamere L … +4 more , Rankin K, Matoba N, Prachand N, Collins JW
Matern Child Health J · 2025 Nov · PMID 40971102 · Full text
OBJECTIVE: To determine the extent to which African-American women's early-life residence in urban neighborhoods with mortgage discrimination (compared to neighborhoods without mortgage discrimination) is associated with...
OBJECTIVE: To determine the extent to which African-American women's early-life residence in urban neighborhoods with mortgage discrimination (compared to neighborhoods without mortgage discrimination) is associated with preterm birth (< 37 weeks, PTB). METHODS: Stratified and multivariable binominal regression analyses were performed on a Chicago transgenerational dataset of African-American women (born 1989-1991) and their infants (born 2005-2017) with appended Home Mortgage Disclosure Act and Index of Concentration at the Extremes (ICE) data. RESULTS: In mortgage discriminated neighborhoods, the proportion of non-Hispanic White residents exceeded that of neighborhoods without mortgage discrimination: 84% vs. 31%, p < 0.01. Additionally, mean ICE for mortgage discriminated neighborhoods equaled 0.78 (0.64-0.91) confirming the greater concentrations of non-Hispanic White populations. African-American women (n = 735) with early-life residence in mortgage discriminated neighborhoods had a PTB rate of 15.8% compared to 13.1% for those (n = 23,369) with early-life residence in non-mortgage discriminated neighborhoods; RR = 1.20 (1.01, 1.43). The adjusted (controlling for trimester of prenatal care usage and cigarette smoking) RR of early (< 34 weeks), late (34-36 weeks), and total PTB for African-American women with early-life residence in mortgage (compared to non-mortgage discriminated) neighborhoods equaled 1.60 (1.20, 2.14), 1.18 (0.92,1.53), and 1.31 (1.09,1.57), respectively. The subgroup of African-American women (n = 536) with early-life residence in mortgage discriminated neighborhoods and adulthood residence in non-mortgage discriminated neighborhoods had an early PTB rate of 8.0% versus 5.1% for those (n = 20,298) with a lifelong residence in non-mortgage discriminated neighborhoods; RR = 1.58 (1.18, 2.12). CONCLUSIONS: Urban African-American women's early-life residence in predominately non-Hispanic White, mortgage discriminated neighborhoods is associated with an increased risk of PTB, particularly its' early component, independent of adulthood risk status.
"Remember One Size Doesn't Fit All": A Scoping Review of Postpartum Supports for Neurodivergent Mothers.
O'Leary N, George CV, ElDirani Z … +2 more , Jenks R, Kent G
Matern Child Health J · 2025 Nov · PMID 40971101 · Full text
INTRODUCTION: Neurodivergence affects how women experience the world and life transitions such as motherhood and the postpartum period. Postpartum supports are designed from a neurotypical perspective and may not meet th...
INTRODUCTION: Neurodivergence affects how women experience the world and life transitions such as motherhood and the postpartum period. Postpartum supports are designed from a neurotypical perspective and may not meet the needs of neurodivergent women. For example, breastfeeding groups may not support the sensory needs of autistic women. The aim of this scoping review was to document postpartum experiences of neurodivergent women. METHODS: A scoping review methodology underpinned this review. The socio-ecological model was used to report findings and generate recommendations. RESULTS: 18 records were included primarily representing experiences of autistic women and women with ADHD. Women reported that acting in the best interests of their baby was their highest priority. This often involved making adaptations that disrupted their coping strategies and engaging in social situations such as baby groups, which required them to accept cultural norms and adopt expected neurotypical behaviours. Healthcare professionals did not always account for the needs of neurodivergent women; in some cases, this led to situations whereby neurodivergent women experienced greater parenting scrutiny. DISCUSSION: This review highlighted a small but growing body of research relating to the postpartum experiences of neurodivergent women. Neurodivergent women need access to tailored supports during the postpartum period as they balance managing the needs of an infant with necessary neurodiversity adjustments. However, there is also a need for greater healthcare professional training specific to supporting neurodivergent women and better public understanding of neurodiversity to ensure neurodivergent women feel safe to be their authentic selves in motherhood.
Prevalence of Postpartum Depression in Adolescents in an Urban Teen Clinic.
Ramos MW, Gonzalez de Corcuera S, Mirabile Y … +3 more , Musaad SMA, Raphael M, Gordon CM
Matern Child Health J · 2025 Nov · PMID 40954403 · Publisher ↗
OBJECTIVES: The purpose of this study was to determine the frequency of postpartum depression (PPD) screening, the prevalence of PPD, and the factors associated with PPD screening amongst adolescents and young adults (AY...
OBJECTIVES: The purpose of this study was to determine the frequency of postpartum depression (PPD) screening, the prevalence of PPD, and the factors associated with PPD screening amongst adolescents and young adults (AYA) at a free urban teen clinic. METHODS: We conducted a retrospective chart review of postpartum visits at a free urban teen health clinic serving AYA ages 13-24. Two trained researchers extracted study data including patient demographics, pregnancy outcomes, time from delivery to first postpartum clinic visit, prenatal mental health diagnoses, and postpartum mental health assessments from charts between 2017 and 2022 with a postpartum visit billing code. RESULTS: 280 charts were retrieved from which nine were excluded. The majority of subjects identified as White and Hispanic or Latino. Ages ranged from 14 to 24 years and most were 18-24 at the time of the infant's birth. 103 (35.2%) were publicly insured and the remainder were uninsured. 140 (51.7%) of patients received PPD screening with the Edinburgh Postpartum Depression Screen or a validated alternative, though the rate of PPD screening significantly improved (p < 0.00001) after clinic flow was changed in 2020. Of those screened (n = 140), the rate of positive scores was 9.9%, lower than expected. CONCLUSIONS FOR PRACTICE: Despite clinical recommendations, only just over half of AYA women had documented mental health screening at the time of postpartum visits. Rates of PPD in this sample were low. As PPD is an adverse childhood event with lifelong implications for the parent and child, efforts to improve PPD screening are warranted.
Correction: 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 Dec · PMID 40952656 · Full text
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Postpartum Opioid Use in the United States and the Implications to Maternal and Public Health: A Scoping Review.
Miller AN, Daniels DEN, Heavey SC
Matern Child Health J · 2025 Nov · PMID 40952655 · Full text
INTRODUCTION/PURPOSE: Postpartum opioid prescription rates remain high, leading to increased morbidity and mortality and increased licit opioid medications diverted into communities. This scoping analysis examined the cu...
INTRODUCTION/PURPOSE: Postpartum opioid prescription rates remain high, leading to increased morbidity and mortality and increased licit opioid medications diverted into communities. This scoping analysis examined the current processes of postpartum opioid prescribing patterns in America and the implications to maternal and public health. METHODS: From the databases PubMed, Medline, and Web of Science, a scoping review was performed utilizing the PRISMA-ScR checklist (Tricco et al. in Ann Intern Med 169(7):467-473, 2018, https://doi.org/10.7326/M18-0850 ). The primary objective of the search strategy was to identify studies that focused on the postpartum timeframe (obstetric delivery to one year postpartum) and prescribed opioids. RESULTS: A total of 26 articles met inclusion criteria. Articles were broken down into four themes: trends or current state of postpartum opioid prescribing practices (n = 7); postpartum opioid related risk factors (n = 6); rates of new persistent opioid use and opioid use disorder (OUD; n = 5); protocols or research into reducing postpartum opioid use (n = 8). DISCUSSION/CONCLUSION: A variety of interventions and protocols have been found to be advantageous in reducing postpartum opioid use. Despite many of these successful efforts, postpartum opioid prescription rates remain high. Implementation of any number of interventions and protocols may be beneficial to reducing postpartum opioid use. Initiating a postpartum pain task force protocol (PPTFP) before obstetric delivery is recommended.
Group Prenatal Care for Afghan Refugees: A Pilot Program and Initial Demonstration of Feasibility.
Aleinikoff S, Maratas AS, Marcell L … +3 more , Mann EM, Dawson-Hahn E, Yu K
Matern Child Health J · 2025 Nov · PMID 40952654 · Publisher ↗
INTRODUCTION: In 2018 approximately 2400 Afghan refugees resettled in Washington state, and with approximately 16% arriving pregnant, many were in need of immediate prenatal care and psycho-social support. Because it has...
INTRODUCTION: In 2018 approximately 2400 Afghan refugees resettled in Washington state, and with approximately 16% arriving pregnant, many were in need of immediate prenatal care and psycho-social support. Because it has been shown to alleviate disparities in pregnancy outcomes, CenteringPregnancy, a group prenatal care model, was chosen as an evidence-based program to meet the needs of this community. This article aims to describe the feasibility and experience of CenteringPregnancy for pregnant refugees from Afghanistan as piloted in a community health center setting in Washington State. METHODS: This retrospective cohort and qualitative analysis utilized pregnancy-related outcome data extracted from electronic health records, as well as post-participation surveys to inform the feasibility of offering CenteringPregnancy in languages other than English. Two separate groups were conducted in 2018-2019 (n = 21) in Dari. RESULTS: Of 21 participants, 95% were reported to have adequate prenatal care as defined by Healthy People 2030 (> 9 visits during pregnancy). Delivery outcomes were generally positive, with no "very low birth weight" babies, and 86% vaginal delivery. Attendance at postpartum visits was 100% and 90% reported using contraception at 3 months postpartum. Post-participation surveys were generally positive; staff and physicians also reported positive views on the program and their participation in it. DISCUSSION: Group prenatal care, delivered as CenteringPregnancy in a community health center, is a feasible option for Afghan refugee women with this pilot demonstrating that patient experience and pregnancy related outcomes are largely positive; in addition to providing staff and physicians high levels of satisfaction with care.
Determinants, Impact and Optimal Resource Allocation of Zambia's Scaling Up Nutrition Program.
Levin A, Sharper S, Pantazis A
Matern Child Health J · 2025 Oct · PMID 40952653 · Publisher ↗
OBJECTIVES: Zambia's Scaling Up Nutrition (SUN) Program is a multi-sectoral program with a package of nutrition-specific and nutrition-sensitive interventions to reduce stunting in children. The purpose of the study was...
OBJECTIVES: Zambia's Scaling Up Nutrition (SUN) Program is a multi-sectoral program with a package of nutrition-specific and nutrition-sensitive interventions to reduce stunting in children. The purpose of the study was to conduct an economic analysis of the SUN Most Critical Days Program (MCDP) II activities during 2018-2022. METHODS: The economic analysis evaluated SUN/MCDP II nutrition interventions through three analyses: (i) estimating their impact on mortality and morbidity since 2018 with the LiST tool, (ii) identifying the determinants of stunting with a Oaxaca Blinder counterfactual decomposition, and (iii) assessing the efficient resource allocation of SUN/MCDP II resources using the Optima Nutrition Tool. RESULTS: The LiST modelling analysis estimated that since 2018, SUN/MCDP II interventions reduced deaths, diarrhoeal incidence, and stunting among children under 5 years of age in all 30 districts. Vitamin A supplementation was the largest contributor to reductions in deaths and diarrhoeal incidence, The Oaxaca Blinder counterfactual decomposition analysis found that the main contributors to stunting decline were access to piped water, maternal education, child birth weight, and basic sanitation in Zambia. The Optima Nutrition analysis revealed that stunting decline could be maximized if more funding is put into the interventions of Vitamin A and WASH interventions as well as adding some other interventions. CONCLUSION FOR PRACTICE: The SUN Program has led to a reduction in childhood stunting as well as mortality. The Program's package of interventions could be further enhanced through optimizing the allocation of resources.
Breastfeeding Conversations with a Home Visitor and Breastfeeding Continuation in Postnatal Enrollees.
Ray MC, Gullick MM, McGinnis SL … +1 more , Kirkland KA
Matern Child Health J · 2025 Nov · PMID 40952652 · Publisher ↗
INTRODUCTION: Breastfeeding is associated with many health benefits for both mothers and children, yet U.S. breastfeeding rates are far below the Healthy People 2030 goals. Furthermore, disparities in breastfeeding rates...
INTRODUCTION: Breastfeeding is associated with many health benefits for both mothers and children, yet U.S. breastfeeding rates are far below the Healthy People 2030 goals. Furthermore, disparities in breastfeeding rates exist, whereby some demographic groups have even lower rates. This study examines the association between dosage of breastfeeding conversations with a home visitor on breastfeeding continuation in participants who enrolled postnatally. METHODS: This cohort study examines the impact of breastfeeding conversations with a home visitor on breastfeeding continuation on 1,422 mother-child pairs enrolled postnatally in Healthy Families New York (HFNY), a family support home visiting program. Multivariable logistic regression models analyzed longitudinal data, adjusting for several known predictors of breastfeeding that could confound the association between breastfeeding conversations and breastfeeding continuation. RESULTS: The analyses reveal a significant association between the rate of breastfeeding conversations during home visits in the preceding period and increased odds of breastfeeding continuation for 1-2 months (p = 0.013), 2-3 months (p < 0.001), 3-6 months (p < 0.001), and six months or greater (p = 0.001). The dose-response relationship and longitudinal nature of the data could suggest causality. Importantly, the impact of breastfeeding conversations is more pronounced among mothers born in the U.S., a group with known disparate breastfeeding outcomes. Further, this study finds that the number of home visits predicts breastfeeding continuation past six months (p < 0.001). DISCUSSION: This study offers important insights into the role of a home visiting intervention to promote breastfeeding and reduce breastfeeding disparities without the excessive costs of an intervention designed solely for breastfeeding.
Medicaid Dental Coverage and Preventive Dental Care Use Among Pregnant Adults.
Reynolds JC, Peter TK, Heeren T … +3 more , Lewis SE, Damiano PC, Xie X
Matern Child Health J · 2025 Dec · PMID 40944802 · Full text
OBJECTIVES: The aim of this study was to examine the relationship between Medicaid dental coverage for pregnant adults and receipt of a dental cleaning during pregnancy among adults with Medicaid. METHODS: In this cross-...
OBJECTIVES: The aim of this study was to examine the relationship between Medicaid dental coverage for pregnant adults and receipt of a dental cleaning during pregnancy among adults with Medicaid. METHODS: In this cross-sectional study, 2019 Pregnancy Risk Assessment Monitoring System data were used to measure individuals' receipt of a dental cleaning during pregnancy and in the year prior to pregnancy. The independent variable was the state-level degree of Medicaid dental coverage for pregnant adults as of 2019, ranging from none to extensive. Weighted logistic regression models estimated the odds of having a dental cleaning during pregnancy, both for the full sample and stratified by whether or not a cleaning was received pre-pregnancy. RESULTS: Approximately one-third (31%) of respondents reported receiving a dental cleaning during pregnancy. In multivariable results, pregnant adults living in states with emergency (OR 0.58, 95% CI 0.41-0.83, p = 0.002) or no (OR 0.60, 95% CI 0.41-0.86, p = 0.006) dental coverage had significantly lower odds of having a dental cleaning during pregnancy than those living in states with extensive dental coverage. This association was concentrated among people who did not have a dental cleaning pre-pregnancy; those without a cleaning pre-pregnancy who lived in a state with extensive dental coverage had approximately twice the odds or more of having a dental cleaning during pregnancy than those who lived in states with emergency or no dental coverage. CONCLUSIONS: Having dental insurance is critically important to be able to access needed dental care and avoid substantial out-of-pocket costs. This study found that for pregnant adults in Medicaid who who hadn't had a dental cleaning in the year prior to pregnancy, having extensive dental coverage was significantly associated with much higher odds of having a dental cleaning during pregnancy relative to having emergency or no dental coverage. Our findings, together with the body of evidence on the impact of Medicaid dental coverage on dental care access, underscore the importance of providing comprehensive dental coverage in Medicaid regardless of age and pregnancy status.
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