Matern Child Health J [JOURNAL]
Sun
200 papers
Improving Perinatal Palliative Care in the Communities: A Regional Population-Based Study.
Takashima K, Hitosugi M, Yamamoto M … +1 more , Maruo Y
Matern Child Health J · 2025 Oct · PMID 40944801 · Full text
OBJECTIVES: Perinatal palliative care, defined as support for creating birth plans that include treatment and care decisions, is crucial for families facing life-threatening fetal conditions. However, the variability in...
OBJECTIVES: Perinatal palliative care, defined as support for creating birth plans that include treatment and care decisions, is crucial for families facing life-threatening fetal conditions. However, the variability in medical resources across communities necessitates the development of tailored, community-based perinatal palliative care systems that support shared decision-making through multidisciplinary care. This study uses child death review (CDR) data to examine the current status and challenges of perinatal palliative care delivery in regional communities, focusing on decision-making processes, care planning, and transition to home care. It also compares cases in which families selected comfort care with those choosing intensive care to explore differences in care processes and outcomes. METHODS: A retrospective cohort study was conducted using regional CDR data from children under 18 years who died in Shiga Prefecture, Japan, between 2018 and 2020. Data on children eligible for perinatal palliative care were primarily collected from perinatal centers and perinatal cooperative hospitals participating in the CDR. RESULTS: Among 131 deaths, 19 involved life-threatening conditions considered for perinatal palliative care. Two lacked prenatal diagnoses, while 17 discussed care plans, including medical intervention options, and mode of delivery. Of these, 65% (11/17) chose comfort care, while 35% (6/17) opted for intensive care. A comparison between these groups showed that the comfort care group had a longer decision-making period (median, 29 vs. 9 days; p = 0.044). Decision support before birth, which included accurate information about fetal conditions, care planning options, and psychological support, was not provided by clinical psychologists or palliative care specialists. Of the 17, four patients were discharged home, and one died at home. CONCLUSIONS FOR PRACTICE: This study highlights the challenges of implementing perinatal palliative care in communities. The prolonged decision-making process associated with comfort care may reflect the significant psychological burden on families. Factors such as care plans influence family burden, emphasizing the need for individualized support. The absence of specialized support and low rates of transition to home care for end-of-life care are critical issue for improvement in community-based perinatal palliative care.
An Evaluation of the Pathways Community HUB Approach To Improving Birth Outcomes: A Retrospective Study Using Propensity Score Matching in Richland, Ohio.
Chiyaka ET, Cheruvu VK, Hoornbeek JA
Matern Child Health J · 2025 Oct · PMID 40932565 · Publisher ↗
INTRODUCTION: Low birth weight (LBW) is one of the most important factors affecting neonatal mortality and is a determinant of post-neonatal mortality. This study aimed to assess the effectiveness of the Pathways Communi...
INTRODUCTION: Low birth weight (LBW) is one of the most important factors affecting neonatal mortality and is a determinant of post-neonatal mortality. This study aimed to assess the effectiveness of the Pathways Community HUB Institute Model (PCHI Model) in improving birth outcomes among high-risk pregnant women. METHODS: In this retrospective study, data were drawn from the Pathways Community HUB Program (Community Health Access Project - CHAP) in Richland, Ohio, and the Ohio Department of Health from 2014 to 2017. We employed a 1:1 nearest neighbor propensity score matching for 315 participating and 315 non-participating women and used conditional logistic regression to analyze our data. The pregnancy outcomes we assessed included preterm birth and birth weight. RESULTS: The incidence of LBW in the Community Health Access Program (CHAP) group was 8.6% compared to 12.4% in the non-CHAP group. CHAP participants had a 43% lower chance of low birth weight births (OR = 0.572, 95% CI = 0.335-0.979), while the program's effect on preterm delivery approached but did not achieve statistical significance (OR = 0.640, 95% CI = 0.407-1.007). We also found that those who entered the CHAP program and those who had their first prenatal care appointment in the first trimester of their pregnancies were less likely to deliver a LBW infant than those who entered the program and had their first prenatal care appointment later in their pregnancies. CONCLUSIONS: Among high-risk pregnant women, the PCHI Model can significantly improve prenatal care utilization and reduce the incidence of LBW infants. In addition, pregnant women participating in the Pathways Community HUB program appeared to benefit more if they entered the program in their first trimester rather than later in their pregnancy, suggesting that longer durations of program participation are associated with better birth outcomes.
A Pilot Program to Promote Maternal and Infant Oral Health Through Collaboration Between Dental and Obstetric Providers: Impact on Dental Visits During Pregnancy.
Clark SJ, Byrappagari D, Sailor L
Matern Child Health J · 2025 Dec · PMID 40932564 · Full text
OBJECTIVES: The Michigan Initiative for Maternal and Infant Oral Health (MIMIOH) program provided funding to federally qualified health centers (FQHCs) to hire and embed a dental hygienist in the obstetrics clinic, with...
OBJECTIVES: The Michigan Initiative for Maternal and Infant Oral Health (MIMIOH) program provided funding to federally qualified health centers (FQHCs) to hire and embed a dental hygienist in the obstetrics clinic, with the goal of increasing the provision of dental care during pregnancy. Ten sites participated in two cohorts. Our objective was to assess the impact of the MIMIOH program on receipt of dental visits during pregnancy. METHODS: Using Medicaid paid claims, we documented quarterly trends in dental visits during pregnancy, describing trends for each MIMIOH sites and comparing aggregate results for MIMIOH Cohorts 1 and 2 vs. FQHCs that did not participate in MIMIOH. RESULTS: The proportion of women with a dental visit during pregnancy varied across MIMIOH sites, and was higher during periods of active participation. For both MIMIOH Cohorts 1 and 2, the aggregate proportions of dental visits during periods of active participation was higher than that for non-MIMIOH FQHCs. In contrast, dental visits were lower for Cohort 1 after MIMIOH participation ended, and for Cohort 2 before MIMIOH began. CONCLUSIONS: The MIMIOH program was successful at increasing dental visits among pregnant women during periods of active participation.
Correction: Effects of a Mobile Health Intervention on Weight Control and Pregnancy Outcomes in Overweight Pregnant Women: A Randomized Controlled Trial.
Su MC, Chao AS, Chang MY … +2 more , Chang YL, Sun JC
Matern Child Health J · 2025 Oct · PMID 40928640 · Publisher ↗
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Associations Between Food Insecurity and Child BMI: Cross-Sectional Versus Longitudinal Mediational Analysis of Maternal Weight-Related Parenting Practices and Concerns.
Shonkoff E, Mason T, Naya C … +1 more , Dunton GF
Matern Child Health J · 2025 Nov · PMID 40928639 · Publisher ↗
OBJECTIVE: To test whether parent restriction, pressure to eat, and maternal concern for child weight mediated the positive association between food insecurity and child body mass index (BMI) in cross-sectional and longi...
OBJECTIVE: To test whether parent restriction, pressure to eat, and maternal concern for child weight mediated the positive association between food insecurity and child body mass index (BMI) in cross-sectional and longitudinal analysis. METHODS: Data were from mother-child pairs (n = 202 at baseline). Children were M = 10.1 y (range 8-12) at baseline, 56% Hispanic, and 49% female; mothers were M = 41.2 y, and 58% had a college education or higher. Mediation models with maximum likelihood multiple imputation were conducted in MPlus, controlling for child age, child gender, and baseline scores on mediator and outcome variables (in longitudinal models). RESULTS: Greater maternal concern for child weight mediated the association between greater food insecurity and higher child BMI in the cross-sectional model (indirect effect = 0.115, p < .010) but not the longitudinal model (indirect effect = < .001, p =.960). No evidence of mediation was found for pressure to eat or restriction in cross-sectional or longitudinal models. In cross-sectional models, food insecurity was associated with higher child BMI (B = 0.20; B = 0.24; B = 0.90, ps <.01); and greater concern with child weight (B = 0.19, p < .01, which was a precondition for mediation). CONCLUSIONS: Current findings suggest that food insecurity is associated with higher subsequent maternal concern for child weight and in turn higher child BMI (cross-sectionally). However, there was no support for feeding practices or concern as longitudinal mediators of food insecurity and child BMI change.
Mental Health Across the Conception Journey: Trying To Conceive Without Treatment, Considering Treatment, and with Treatment.
Henrich N, Jahnke HR
Matern Child Health J · 2025 Oct · PMID 40926166 · Full text
BACKGROUND: While it is well established that trying to conceive while experiencing infertility and undergoing fertility treatment is associated with anxiety, little is known about the mental health toll of trying to con...
BACKGROUND: While it is well established that trying to conceive while experiencing infertility and undergoing fertility treatment is associated with anxiety, little is known about the mental health toll of trying to conceive without fertility treatment. Minimal contact with the healthcare system while trying to conceive without treatment contributes to low rates of detection and support for this population. OBJECTIVE: This research aims to provide formative insights into the prevalence of mental health distress and desire for emotional support among people who are trying to conceive without treatment, and how this compares to people who are considering or using fertility treatment. METHODS: This retrospective cohort study included 3,458 US-based individuals who used Maven, a comprehensive digital platform for reproductive and women's health. Descriptive statistics and bivariate tests were used to determine differences in prevalence of depression, anxiety, conception-specific anxiety, and interest in receiving emotional support at various stages of the trying to conceive pathway. RESULTS: Users trying to conceive without treatment, considering treatment, and using treatment screened positive at comparable rates for depression (4.1%, 4.2%, 4.6%; p = 0.82), generalized anxiety (7.5%, 8.9%, 8.8%; p = 0.77), and conception-specific anxiety (22.0%, 23.5%, 20.4%; p = 0.13). Interest in receiving emotional support was lowest in people trying to conceive without treatment, higher among people considering treatment, and highest among people using treatment (32.0%, 34.6%, 39.5%; p = 0.005), respectively. CONCLUSIONS: People trying to conceive without treatment had comparable rates of anxiety and depression to users considering or undergoing treatment. Across all groups, more than 30% of users reported interest in support for their emotional well-being. Primary care providers and digital health platforms can screen and support this population.
Effects of Liver Enzyme Levels During Pregnancy on Birth Weight.
Li Q, Pan M, Chen J … +9 more , Shi H, Zhang Q, Liu W, Gao H, Li W, Wu Z, Sun B, Zhu Y, Li H
Matern Child Health J · 2025 Oct · PMID 40911124 · Publisher ↗
OBJECTIVES: To investigate the association between maternal liver enzyme concentrations during pregnancy and the risk of abnormal birth weight. METHODS: This is a prospective birth cohort study querying the pregnant wome...
OBJECTIVES: To investigate the association between maternal liver enzyme concentrations during pregnancy and the risk of abnormal birth weight. METHODS: This is a prospective birth cohort study querying the pregnant women from Fujian Maternal and Child Health Hospital, affiliated with Fujian Medical University, China. Liver enzyme levels, including gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), were measured in the first and third trimesters, and changes in liver enzyme levels were calculated based on these measurements. The outcomes were birth weight, small for gestational age (SGA), large for gestational age (LGA), low birth weight (LBW), and macrosomia. RESULTS: The study analyzed 19,003 singleton pregnancies with live births. The mean age of the pregnant individuals was 30.3 ± 3.9 years, 18,594 patients (97.8%) were Han. GGT in the first trimester is positively correlated with the risks of macrosomia and LBW, mediated through gestational diabetes mellitus (GDM) and gestational age at birth, respectively. Nonlinear regression models suggested that there was a linear relationship of liver enzyme levels during pregnancy with LBW and SGA (P for non-linear > 0.05). According to regression analysis, changes in liver enzyme levels during pregnancy were negatively correlated with birth weight, LGA, and macrosomia, and positively correlated with the risk of SGA. Similar results were found for liver enzymes in late pregnancy. CONCLUSIONS: The concentration and even the changes of liver enzymes during pregnancy may influence the fetus's birth weight to different degrees. Thereby, monitoring liver enzyme levels during pregnancy could help prevent abnormal fetal development.
Efficacy of an Online Nursing Consultation to Encourage Breastfeeding.
Araque García J, Pedraz Marcos A, Alba Diego RM … +2 more , Palmar Santos A, García Perea ME
Matern Child Health J · 2025 Oct · PMID 40911123 · Publisher ↗
OBJECTIVE: To evaluate the efficacy of an online nursing consultation on the Red Sinapsis (RS) Internet platform in increasing maternal self-efficacy and exclusive breastfeeding rates during the first month postpartum. M...
OBJECTIVE: To evaluate the efficacy of an online nursing consultation on the Red Sinapsis (RS) Internet platform in increasing maternal self-efficacy and exclusive breastfeeding rates during the first month postpartum. METHODS: This study employed a controlled, randomised experimental design with two groups. Ninety women who had undergone caesarean sections were randomly assigned to either an intervention group (n = 45) or a control group (n = 45). The intervention group received follow-up care from a breastfeeding expert nurse on the RS online platform, while the control group received standard follow-up care from a midwife or primary care nurse. Breastfeeding success was measured using the LATCH scale at 15 days postpartum and the BSES-SF scale at 30 days postpartum. For comparative analysis between study groups, Fisher's exact test or the chi-squared test was used, depending on the contingency table dimensions. Missing values were not imputed. P-values below the 0.05 threshold were considered statistically significant. RESULTS: A total of 84% of the intervention group showed greater confidence in providing breast milk to their children, compared to 44% of the control group (p < 0.001). The intervention group also achieved better outcomes in terms of believing that breastfeeding alone is sufficient to nourish their baby, with 82% expressing confidence, compared to 59% in the control group (p = 0.041). CONCLUSIONS: Online nursing follow-up during the immediate postpartum period improves maternal confidence in breastfeeding, promoting its initiation and establishment during the first month postpartum.
Care Coordination Satisfaction Survey for Families of Children and Youth with Special Healthcare Needs.
Hofmann M, Perez PC, Barack R
Matern Child Health J · 2025 Oct · PMID 40911122 · Full text
INTRODUCTION: Care coordination can be an essential source of support to families of children with special health care needs and should ideally lead to improvements in the organization of care. PURPOSE: This publication...
INTRODUCTION: Care coordination can be an essential source of support to families of children with special health care needs and should ideally lead to improvements in the organization of care. PURPOSE: This publication aims to share the experience of one statewide Title V organization's work to develop and validate a care coordination satisfaction survey. DESCRIPTION: UIC-DSCC engaged with the Family Advisory Council and a Family Survey Committee to revise existing surveys measuring different care coordination domains. The overall consensus was to apply a 13-item annual care coordination satisfaction survey. The survey was administered to families between January and April 2023. Psychometric reviews included exploratory Factor Analysis for the underlying structure of the items and Cronbach α for reliability. A top-box approach was used to represent item proportion. ASSESSMENT: 899 families completed the 13-item measure. The Exploratory Factor Analysis determined a 2-factor solution: (1) Care Coordination Satisfaction and (2) Engagement and Impact on Quality of Life-none of the items required removal. Factor 1's top-box results show families' positive experience with care coordination, with 6.37 of the seven questions being answered with the most favorable answer. Similarly, in factor 2, 5.28 of the six questions were responded to with the top or most favorable answer. CONCLUSION: Family partnership is a crucial part of the care coordination process, and UIC-DSCC has learned that this partnership is also critical when evaluating family satisfaction with care coordination services. The 13-item care coordination survey demonstrated adequacy and can assist with quality improvement in care coordination programs.
Assisted Infant Toilet Training and Bladder and Bowel Health: A Global Integrative Review.
Hindmarsh C, Davis D, Atchan M
Matern Child Health J · 2025 Oct · PMID 40911121 · Full text
BACKGROUND: Toilet training practices vary across cultures and time. Assisted Infant Toilet Training (AITT) is commonly used in low- and middle-income countries. OBJECTIVES: To synthesise the literature on AITT, includin...
BACKGROUND: Toilet training practices vary across cultures and time. Assisted Infant Toilet Training (AITT) is commonly used in low- and middle-income countries. OBJECTIVES: To synthesise the literature on AITT, including timing of initiation and completion, infant elimination signalling, and associations with bladder and bowel dysfunction. METHODS: An integrative review methodology was employed. Comprehensive searches of Scopus, Medline, CINAHL, Web of Science, PsycINFO, and Google Scholar identified relevant studies. Two reviewers independently screened and appraised studies using GRADE and JBI tools. RESULTS: Of 2,069 studies identified, 21 met inclusion criteria. Six observational studies reported reduced rates of bladder and bowel dysfunction when AITT was practised. DISCUSSION: AITT is widely practised in low-income, non-English speaking countries. While observational studies suggest a potential protective effect on bladder and bowel health, the evidence is at serious risk of bias. Further prospective research in high-income contexts is warranted.
Promoting Kindergarten Readiness in Primary Care: Perspectives of Children's Primary Care Providers.
Dever R, Wekon-Kemeni C, Reynolds A … +4 more , Steiner MJ, Young J, Cholera R, Flower KB
Matern Child Health J · 2025 Dec · PMID 40906004 · Publisher ↗
BACKGROUND AND OBJECTIVE: Children's healthcare providers have important roles in kindergarten readiness. We sought to understand children's primary care providers' (PCP) current approaches to fostering kindergarten read...
BACKGROUND AND OBJECTIVE: Children's healthcare providers have important roles in kindergarten readiness. We sought to understand children's primary care providers' (PCP) current approaches to fostering kindergarten readiness for their patients, perceptions of barriers, and ideas for improvement. METHODS: Children's PCPs were recruited and interviewed between June and August 2021. Interviews were audio recorded, transcribed, and iteratively analyzed to identify and refine emerging themes. RESULTS: Eleven PCPs were interviewed from eleven unique practices across rural and urban settings in North Carolina. Key themes included (1) Integrating kindergarten readiness in the primary care clinic, (2) Partnering with communities to improve kindergarten readiness, and (3) Promoting equity to improve kindergarten readiness. Within the clinic, PCPs valued extended care teams and dedicated assessment tools. PCPs reported wanting greater collaboration with schools and community organizations and more transparent assessment and referral processes. PCPs identified inequities within existing systems and called for more culturally inclusive, equitable kindergarten readiness promotion. Recommendations included removing cultural and language bias from assessments, improving racial/ethnic concordance, and advocating for supportive systems-level policies. CONCLUSIONS: Children's PCPs identified many current and future opportunities to partner with families and communities to optimize children's school readiness throughout early childhood. Many school readiness promoting activities recommended by PCPs in this study could be supported through quality measures that track and provide financing for these specific actions.
Partner History of Problematic Substance Use and Self-Reported Substance Use During Early Pregnancy: Findings from Kaiser Permanente Northern California, 2021-2022.
Gallegos R, Slama NE, Duggan MC … +3 more , Ansley D, Castellanos C, Young-Wolff KC
Matern Child Health J · 2025 Nov · PMID 40900197 · Publisher ↗
OBJECTIVES: The role of partner substance use as a risk factor for prenatal substance use remains understudied. This study aimed to investigate the association between self-reported partner history of problematic substan...
OBJECTIVES: The role of partner substance use as a risk factor for prenatal substance use remains understudied. This study aimed to investigate the association between self-reported partner history of problematic substance use and pregnant persons use of alcohol, cannabis, e-cigarettes, and tobacco during early pregnancy. METHODS: A total of 82,180 pregnant individuals screened for substance use in Kaiser Permanente Northern California at their first prenatal visit (approximately 8-10 weeks gestation) during 2021-2022 were included. Partner substance use and prenatal substance use were determined via a self-administered questionnaire. Cannabis use was additionally determined by urine toxicology. Adjusted odds ratios (aOR) were calculated using binomial and multinomial logistic regression. RESULTS: Among 82,180 pregnant people, 1,010 (1.2%) reported having a partner with history of problematic substance use. Partner history of problematic substance use was associated with higher adjusted odds of any prenatal substance use (aOR = 1.80; 95%CI:1.56-2.08) and prenatal alcohol (aOR = 1.58; 95%CI:1.33-1.87), cannabis (aOR = 1.89; 95%CI:1.57-2.27), e-cigarette (aOR = 3.38; 95%CI:2.43-4.58), and tobacco use (aOR = 3.66; 95%CI:2.63-4.96). Additionally, frequency analyses showed that a partner history of problematic substance use was associated with higher odds of weekly or daily and monthly or less substance use compared to no use. CONCLUSIONS: Self-reported partner history of problematic substance use was associated with increased odds of prenatal use of alcohol, cannabis, e-cigarettes, and tobacco during early pregnancy. Findings suggest that individuals with a partner with problematic substance use may benefit from targeted prevention prior to pregnancy to reduce substance use during pregnancy.
Adverse Childhood Experiences and Antenatal Depression: The Mediating Role of Social Support.
Chiang WL, Yu CY
Matern Child Health J · 2025 Dec · PMID 40892351 · Full text
INTRODUCTION: This study aimed to examine the association between adverse childhood experiences (ACEs) and antenatal depression among women in Taiwan and investigate the mediating effects of partner support and social su...
INTRODUCTION: This study aimed to examine the association between adverse childhood experiences (ACEs) and antenatal depression among women in Taiwan and investigate the mediating effects of partner support and social support on that relationship. METHODS: An online survey was conducted, and 456 women aged ≥ 20 years with childbirth experience responded. The participants were asked to recall and self-report their childhood experiences and their perceived social support and mental health status during pregnancy. Linear regression was used to test the association between ACEs and antenatal depression, and causal mediation analysis was performed to analyze the mediating effects of partner support and social support. RESULTS: More than 85% of the participants had experienced at least one type of ACE, and 25.8% reported experiencing four or more ACEs. Our findings indicated that ACEs were associated with antenatal depression. We also found that participants who reported emotional abuse had the highest scores for antenatal depression, followed by those who reported a household member being treated violently and those who reported sexual abuse. Moreover, women with more ACEs were more likely to suffer from antenatal depression. Mediation analysis revealed that partner support and social support accounted for 20.23% and 36.83%, respectively, of the associations between ACEs and antenatal depression. DISCUSSION: The findings of this study suggest that ACEs have a pervasive impact on antenatal depression. Early intervention to prevent ACEs as well as improvements to the availability of social support for pregnant women should be provided to prevent antenatal depression, which will in turn improve fetal growth and development.
Correction: Intimate Partner Violence against Indigenous Women and Association with Stunting and Anemia in Children: A Mixed Approach in Chimborazo-Ecuador.
Rivadeneira MF, Naranjo MD, Barrera MF … +5 more , Trujillo P, Montaluisa MA, Moncayo AL, Grijalva D, Torres AL
Matern Child Health J · 2025 Dec · PMID 40889058 · Full text
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The Association Between Infertility Treatment and Birth Outcomes for Nulliparous Persons Who Gave Birth 35 Years and Older: Findings from 2022 National Vital Statistics System Natality Data.
Gallivan SU, Yee LM, Freedman A … +1 more , Feinglass J
Matern Child Health J · 2025 Oct · PMID 40889057 · Full text
OBJECTIVES: This study uses 2022 National Vital Statistics System natality data to identify characteristics associated with infertility treatment among nulliparous individuals 35 years or older, comparing pregnancy and b...
OBJECTIVES: This study uses 2022 National Vital Statistics System natality data to identify characteristics associated with infertility treatment among nulliparous individuals 35 years or older, comparing pregnancy and birth outcomes between no infertility treatment and assisted reproductive technology (ART) or fertility-enhancing drugs or intrauterine insemination (IUI). METHODS: The likelihood of infertility treatment was estimated after controlling for maternal age, education, race and ethnicity, insurance status, Women, Infants and Children (WIC) support, pre-pregnancy body mass index (BMI), chronic hypertension, diabetes, and smoking during pregnancy. Maternal outcomes (gestational diabetes, hypertensive disorders of pregnancy, cesarean birth, maternal morbidity) and neonatal outcomes (preterm birth, low birth weight, neonatal intensive care, and congenital anomalies) were compared for singleton and multifetal births separately. RESULTS: Among 173,399 births, 13.6% had infertility treatment (10.9% ART, 2.4% IUI). As compared to people who identified as white or Asian, infertility treatment was over one-third less likely for non-Hispanic Black and Hispanic individuals and 2.4 times more likely for those with a graduate degree as compared to those with less than high school. Infertility treatment was associated with significantly higher rates of all adverse maternal and neonatal outcomes, and among multifetal births, ART was associated with a higher rate of maternal morbidity and more frequent gestational diabetes. CONCLUSIONS FOR PRACTICE: Disparities in infertility treatment exist. ART was associated with modest but significantly worse outcomes, particularly for singleton births. Continued monitoring of infertility treatment selection and birth outcomes is needed for informed clinical and public policy decisions.
Hypertension and Polycystic Ovary Syndrome Among Women in a Nationwide Electronic Health Records Dataset in the United States.
He S, Imoisili O, Kompaniyets L … +3 more , Lundeen EA, Kuklina EV, Jackson SL
Matern Child Health J · 2025 Oct · PMID 40889056 · Full text
INTRODUCTION: Both hypertension and polycystic ovary syndrome (PCOS) are risk factors for future cardiovascular diseases among women of reproductive age (18-44 years). We constructed an electronic health record (EHR)-bas...
INTRODUCTION: Both hypertension and polycystic ovary syndrome (PCOS) are risk factors for future cardiovascular diseases among women of reproductive age (18-44 years). We constructed an electronic health record (EHR)-based PCOS phenotype, reported PCOS prevalence, and investigated the association of PCOS and hypertension in the United States (US). METHODS: This cross-sectional study used 2022 IQVIA's Ambulatory Electronic Medical Record (AEMR)-US data (May 2023 release). We constructed a phenotype for PCOS and reported PCOS prevalence for eligible women. We then described hypertension prevalence and hypertension control estimates stratified by PCOS status. Lastly, we calculated adjusted prevalence ratios (aPR) for hypertension and hypertension control by PCOS status, adjusting for age, race, and body mass index (BMI). RESULTS: We analyzed records for 1,301,425 eligible women, with mean (standard deviation) age of 31.5 (7.9) years. The prevalence of PCOS was 2.1%, but increased with weight category, reaching 6.7% among those with class 3 obesity (BMI ≥ 40 kg/m). Women with PCOS had 50% higher prevalence of hypertension than those without PCOS (aPR 1.50; 95% confidence interval [CI]: 1.48-1.52; p < 0.001), and slightly higher hypertension control prevalence (aPR 1.14; 95% CI: 1.12-1.17; p < 0.001). DISCUSSION: Using a nationwide EHR dataset, we observed that women with PCOS had substantially higher hypertension prevalence than those without PCOS. PCOS prevalence was lower than previous estimates from global surveys. Following guideline-recommended blood pressure screening for women with PCOS could reduce the risk of long-term cardiovascular disease.
Racial/Ethnic Differences in Gestational Diabetes and Its Association with Maternal and Neonatal Outcomes among Women in Hawai'i.
Chern I, Choi SY, Ahn HJ … +2 more , Mau M, Yamasato K
Matern Child Health J · 2025 Dec · PMID 40889055 · Publisher ↗
OBJECTIVES: To assess racial/ethnic differences in gestational diabetes mellitus (GDM) prevalence in Hawai'i. METHODS: This retrospective cross-sectional study included hospital deliveries at Kapi'olani Medical Center fo...
OBJECTIVES: To assess racial/ethnic differences in gestational diabetes mellitus (GDM) prevalence in Hawai'i. METHODS: This retrospective cross-sectional study included hospital deliveries at Kapi'olani Medical Center for Women and Children (Honolulu, Hawai'i) from 2009 to 2019. For birthing people with multiple deliveries during the study interval, only the last delivery was included. Birthing people with pregestational diabetes, delivery < 29 weeks, and multifetal gestations were excluded. GDM was identified through ICD-9 and -1 0 codes. Race and ethnicity were self-reported. Maternal body mass index (BMI) was recorded at delivery admission. GDM prevalence was determined for each race and the odds examined using logistic regression, also adjusting for maternal age and BMI. For analysis, three racial groups were sub-grouped into six ethnic categories as described: the three major racial groups were: (i) Asian, (ii) Native Hawaiian/Pacific Islander, and (iii) White. Six major ethnic sub-categories in the Asian racial group included: East Asians-identified as (1) Chinese/Taiwanese, (2) Japanese/Okinawan, (3) South East Asians identified as Filipino, (4) Native Hawaiian and (5) Pacific Islander identified as Micronesian/Samoan, and (6) White. RESULTS: Of 57,031 deliveries, 31,663 were included in this study. Overall crude prevalence of GDM was estimated at 11.7%. The three Asian ethnic sub-categories had approximately twice the risk of GDM when compared to Whites (Filipina: OR 2.59, 95% CI = [2.27-2.96], Chinese/Taiwanese: OR = 2.38, 95% CI = [2.01-2.82], and Japanese/Okinawan: OR = 1.71, 95% CI = [1.47-1.99]). Native Hawaiians also had higher GDM prevalence estimates compared to Whites (OR = 1.50, 95% CI = [1.31-1.71]), though there was no significant difference for Pacific Islanders (OR = 1.14, 95% CI = [0.97-1.33]). CONCLUSIONS: Prevalence of GDM in hospitalized deliveries in Hawai'i's multi-ethnic population of women has increased nearly 2-fold in the last two decades. All Asian Americans remain at highest risk despite lower maternal BMI at delivery. NH women are younger yet have similar frequency of co-morbidities and comprise the largest proportion of GDM cases overall.
Vaccination Coverage and Determinants Among Children Aged 12-35 Months Following Internal Conflict in Yemen: Insights from a Nationwide Population-Based Survey.
Dadras O, El Saaidi C
Matern Child Health J · 2025 Dec · PMID 40889054 · Full text
INTRODUCTION: Child vaccination is a crucial public health indicator, especially in conflict-affected regions. Despite the benefits, vaccination rates in Yemen remain suboptimal. This study evaluates vaccination coverage...
INTRODUCTION: Child vaccination is a crucial public health indicator, especially in conflict-affected regions. Despite the benefits, vaccination rates in Yemen remain suboptimal. This study evaluates vaccination coverage and its correlates among children aged 12-35 months in Yemen. METHODS: Data from the Yemen Multiple Indicator Cluster Survey (MICS) 2022-23 were used. The survey covered 22 governorates, using a two-stage household selection process, and included 7,796 children. Vaccination status was assessed using a binary composite variable for full immunization. Multilevel logistic regression with robust error variance identified predictors of full vaccination. RESULTS: The overall vaccination coverage was 29%, with urban areas (41%) having higher rates compared to rural areas (25%). Female children had slightly lower odds of being fully vaccinated than male children, though not statistically significant. First-born children had the highest vaccination rates (31%), with odds decreasing with higher birth order. Mothers' secondary or higher education (AOR: 1.59, 95% CI: 1.19-2.13), receiving prenatal care (AOR: 1.97, 95% CI: 1.26-3.07), and reading newspapers at least once a week (AOR: 1.72, 95% CI: 1.21-2.44) were significant positive predictors. Higher fathers' education, fewer children under five in the household, higher household wealth, and urban residence were also associated with higher vaccination rates. Other factors such as hospital delivery, TV watching, internet access, and mobile phone ownership were not significantly associated with full vaccination after adjustment. CONCLUSION: Significant gaps in immunization coverage among children in Yemen, particularly in rural areas, highlight the need for educational programs for parents, enhanced healthcare infrastructure, and improved health communication strategies.
Association of Eliminating Waiting Periods for the Children's Health Insurance Program with Children's Enrollment.
Eliason EL, Trivedi A, Vivier P
Matern Child Health J · 2025 Oct · PMID 40884693 · Full text
OBJECTIVES: Prior to the Affordable Care Act (ACA), over two-thirds of states mandated that children had to be uninsured for set periods of time before enrolling in the Children's Health Insurance Program (CHIP), referre...
OBJECTIVES: Prior to the Affordable Care Act (ACA), over two-thirds of states mandated that children had to be uninsured for set periods of time before enrolling in the Children's Health Insurance Program (CHIP), referred to as waiting periods. The ACA required that waiting periods could not exceed 90 days, leading states to reduce and eliminate waiting periods in response. This study aimed to examine the association between state waiting period elimination under the ACA with children's enrollment in CHIP. METHODS: We used 2010-2019 annual state enrollment data from the Centers for Medicare & Medicaid Services to calculate the proportion of children enrolled in CHIP among 20 states that eliminated waiting periods compared to 14 who maintained them. We estimated difference-in-difference models to assess the association between waiting period elimination with children's CHIP enrollment. RESULTS: In states that eliminated waiting periods, there were significant increases from 10.86% (95% CI: 9.51-12.21) of children enrolled in CHIP in the pre-policy period to 13.43% (95% CI: 12.21-14.66) after the ACA policy change. In adjusted difference-in-difference models, state waiting period elimination was associated with a 1.75% point (95% CI: 0.43-3.11) increase in children's enrollment in CHIP relative to states that maintained waiting periods, representing a 16% enrollment increase from pre-policy baseline levels. CONCLUSIONS: Waiting period elimination under the ACA led to modest but significant increases in CHIP enrollment among children. Our results suggest potential CHIP enrollment benefits from the elimination of waiting periods that were maintained in 9 states.
Covid-19 Pandemic, Isolation and Birth: An Analysis of the Experiences of Women Having Given Birth during this Period in Quebec.
Gagnon R, Champagne-Poirier O, Lefebvre J
Matern Child Health J · 2025 Oct · PMID 40839046 · Full text
INTRODUCTION: The health restrictions surrounding pregnancy, birth, and postnatal care imposed during the COVID-19 pandemic have exacerbated the fears and difficulties generally associated with maternity. Since little re...
INTRODUCTION: The health restrictions surrounding pregnancy, birth, and postnatal care imposed during the COVID-19 pandemic have exacerbated the fears and difficulties generally associated with maternity. Since little research has been done, we wished to better understand the consequences of these changes on the maternity experience of Quebec women. METHODS: During our qualitative research, we analyzed the experiences of Quebec women who went through pregnancy, birth, and postpartum amid the pandemic. These experiences were shared in 366 posts selected from four Facebook groups on maternity and through 20 semi-structured interviews. The data derived from this convenience sample were analyzed following a non-linear trajectory where data collection was interspersed with analysis sessions. RESULTS: For the women involved in this research, the pandemic has mainly impacted (1) their perception of what constitutes a normal experience of maternity care; (2) their perceived need for support and services to address the risks related to the pandemic; and (3) what they consider symbolic milestones associated with maternity. DISCUSSION: Our findings underscore the significance of considering the interpretation attributed to care and services amidst alterations or interruptions (as was the case during COVID-19). The backdrop of the global crisis has caused women to perceive a sense of incompletion in their experience of maternity through the loss of certain key moments, and even to look to the future with trepidation. Consequently, we anticipate enduring ramifications arising from the pandemic, and we encourage healthcare personnel to remain attentive towards women who have given birth during this period of crisis.
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