Matern Child Health J [JOURNAL]
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200 papers
Maternal Sociodemographic Factors, Adiposity, and Pregnancy Outcomes Among Preterm Deliveries Admitted to the Neonatal Intensive Care Unit.
Lipa MC, Soepnel LM, Flammersfeld E … +6 more , Adam K, Organ J, Choo-Kang C, Amin S, Boyd B, Dugas L
Matern Child Health J · 2025 Sep · PMID 40759843 · Full text
INTRODUCTION: Preterm birth represents about 10% of all births in the United States and is known to be influenced by maternal factors, including pre-pregnancy adiposity, measured using BMI. Pre-pregnancy adiposity is inf...
INTRODUCTION: Preterm birth represents about 10% of all births in the United States and is known to be influenced by maternal factors, including pre-pregnancy adiposity, measured using BMI. Pre-pregnancy adiposity is influenced by environmental and sociodemographic factors. This exploratory analysis aimed to explore the complex relationship between pre-pregnancy adiposity, sociodemographic factors, and delivery outcomes among preterm deliveries. METHODS: In this retrospective record review study, participants were mothers of infants born before 34 weeks and 6 days gestational age (GA) and admitted to the NICU at Loyola University Medical Center between 2018 and 2020. Maternal data were extracted using EPIC electronic medical record review. We used Chi-square test/Fisher's exact test for categorical variables and Kruskal-Wallis or Mann-Whitney U tests for continuous variables to test for significance across BMI categories. An exploratory multiple linear regression analysis to test the association between gestational age at delivery, obesity/overweight, socioeconomic status, and ethnicity/race was performed and supplemented with permutation testing. Statistical significance was set at p < 0.05. RESULTS: Among the 27 included participants, the median maternal age was 34 years. The prevalence of pre-pregnancy obesity was 42.9%. Women with obesity/overweight tended to have a lower GA at delivery than women with a normal pre-pregnancy BMI (29.5 weeks vs. 31 weeks, p = 0.073). GA at delivery trended positively with higher socioeconomic status (B = 4.2, 95%CI 1.4-7.0, p = 0.007), and inversely with having overweight/obesity (B=-3.6, 95%CI -5.7- -1.6, p = 0.002), and identifying as non-Hispanic Asian or non-Hispanic Black race/ethnicity (B=-6.3, 95%CI -10.3- -2.4, p = 0.005 and B=-0.50, 95%CI -7.8- -2.2, p = 0.002, respectively). DISCUSSION: In addition to adiposity, race, ethnicity, and socioeconomic status may be associated with more severe preterm delivery (lower GA). While this exploratory study is limited by the small sample size, our findings highlight the impact of sociodemographic factors on maternal obesity and severity of pregnancy complications in the context of preterm birth with NICU admission.
Introduction to Special Issue on Maternal and Child Health History: Looking Back to Move Forward.
Kotelchuck M, Klein Walker D
Matern Child Health J · 2025 Aug · PMID 40742691 · Publisher ↗
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Hospital Breastfeeding Support during the Early Coronavirus Disease 2019 (COVID-19) Pandemic: Worsening Care for Black, Hispanic, and Asian Mothers.
Lazar Tucker J, Arcoleo K, DiTomasso D … +3 more , Oaks BM, Cabral H, São-João T
Matern Child Health J · 2025 Sep · PMID 40711678 · Full text
OBJECTIVES: This study examines changes in Baby Friendly Hospital Initiative (BFHI) key clinical practices in US hospitals during the early coronavirus disease 2019 (COVID-19) pandemic (April– December 2020) compared to...
OBJECTIVES: This study examines changes in Baby Friendly Hospital Initiative (BFHI) key clinical practices in US hospitals during the early coronavirus disease 2019 (COVID-19) pandemic (April– December 2020) compared to before the pandemic. METHODS: Using data from PRAMS (Pregnancy Risk Assessment Monitoring System) between 2016 and 2020, we conducted linear regression analyses to calculate the percentage-point change in BFHI key clinical practices overall and by race and ethnicity. RESULTS: A total of 73,380 new mothers were included in our analyses. Overall, receipt of ideal breastfeeding care declined during the pandemic [(pp -1.6, 95% CI (-2.7, -0.4)]. Among racial and ethnic subgroups, declines were noted for Black non-Hispanic [pp -3.4, 95% CI (-6.0, -0.8)], English-speaking Hispanic [pp -3.2, 95% CI (-6.0, -0.4)], Spanish-speaking Hispanic [pp -3.1, 95% CI (-6.1, -0.1)], and Asian/Pacific Islander [pp -4.0, 95% CI (-7.0, -1.0)] mothers; no changes were noted for White non-Hispanic, American Indian/Alaskan Native non-Hispanic, or Mixed Race non-Hispanic respondents. CONCLUSIONS FOR PRACTICE: The COVID-19 pandemic decreased receipt of the BFHI key clinical practices and exacerbated disparities in evidence-based breastfeeding care for Black non-Hispanic, Hispanic, and Asian/Pacific Islander non-Hispanic mothers. Future research is needed to determine if breastfeeding care has returned to pre-pandemic levels and, if not, to develop strategies to improve breastfeeding care for those most affected by the pandemic.
Assessing Change in Medical Management of Early Pregnancy Loss before and after Implementation of a Learning Collaborative for Initiation of Mifepristone Use.
Hennessey C, Wu L, Harriett L … +5 more , Nutting K, McHugh A, Chor J, Lauderdale D, Stulberg D
Matern Child Health J · 2025 Sep · PMID 40691661 · Publisher ↗
OBJECTIVES: ExPAND Mifepristone is a one-year learning collaborative providing support for mifepristone provision in primary care for early pregnancy loss (EPL) or abortion. This study measured change in prevalence of me...
OBJECTIVES: ExPAND Mifepristone is a one-year learning collaborative providing support for mifepristone provision in primary care for early pregnancy loss (EPL) or abortion. This study measured change in prevalence of medical management of EPL at a federally qualified health center (FQHC) that participated in ExPAND Mifepristone's pilot year. Secondary objectives were to describe changes in referral patterns and medication choice for EPL. METHODS: To quantify changes in medical management of EPL, we conducted a retrospective data query using International Classification of Diseases-10 codes during two time periods: pre-implementation (January 1, 2019 - February 29, 2020) and post-implementation (August 1, 2021 - June 30, 2022). Manual chart review was used to assess change in referral patterns for EPL. RESULTS: There were 193 patients with EPL in the pre-implementation period and 115 post-implementation. Pre-implementation, 8.3% (n=16) of EPL patients received medical management versus 15.7% (n=18) post-implementation (p=0.046). The percentage of all patients with EPL who received misoprostol alone was 8.3% pre- and 8.7% (p=0.91) post-implementation. Treatment with mifepristone plus misoprostol increased to 44.4%. EPL referrals to Obstetrics/Gynecology (OB/GYN) decreased from 14.0% to 1.7% (p=0.001). The most frequent reason for referral was procedural management. CONCLUSION: After participation in ExPAND Mifepristone, there was an increase in medical management for EPL by PCPs and referrals to OB/GYN declined. ExPAND Mifepristone can help facilitate PCP use of mifepristone plus misoprostol for medical management of EPL. KEY WORDS: Primary Care, Early Pregnancy Loss, Mifepristone, Women's Health, Referral.
Parenting Stress in Households Experiencing Food Insecurity: Mental Health as a Mediator?
Engel K
Matern Child Health J · 2025 Sep · PMID 40690156 · Full text
OBJECTIVES: To examine associations between food insecurity and parenting stress and assess the extent to which parent and child mental health explain these associations. METHODS: Cross-sectional data from the 2016-2019...
OBJECTIVES: To examine associations between food insecurity and parenting stress and assess the extent to which parent and child mental health explain these associations. METHODS: Cross-sectional data from the 2016-2019 National Survey of Children's Health (N = 72,763) were pooled to compare parenting stress between households experiencing different levels of food insecurity. Tests were then performed to determine whether parent and child mental health mediates the association between food insecurity and parenting stress. RESULTS: Parents in households experiencing mild food insecurity had parenting stress scores that were 0.23 standard deviations higher than parents in food secure households. These parents were also 1.23% points (161.84%) more likely to report handling the demands of parenting poorly compared to parents in food secure households. The association between parenting stress and food insecurity increased in magnitude with more severe household food insecurity; parents in households experiencing moderate-to-severe food insecurity had parenting stress scores that were 0.46 standard deviations higher than parents in food secure households, and these parents were 4.3% points (565.79%) more likely to report handling the demands of parenting poorly compared to parents in food secure households. Differences in child and parent mental health explained only some of the identified disparities in parenting stress.
Social, Demographic and Health Risk Factors for Head Growth in Infants in Rural Guatemala: A Prospective Cohort Study.
Connery AK, Becker-Dreps S, Calvimontes DM … +5 more , Roell Y, Colbert AM, Olson D, Asturias EJ, Lamb MM
Matern Child Health J · 2025 Oct · PMID 40682606 · Publisher ↗
OBJECTIVES: We explored social, demographic, and health risk factors for occipitofrontal circumference (OFC) growth in infants living in a rural, low-resource region of Guatemala. METHODS: OFC was measured at enrollment...
OBJECTIVES: We explored social, demographic, and health risk factors for occipitofrontal circumference (OFC) growth in infants living in a rural, low-resource region of Guatemala. METHODS: OFC was measured at enrollment (0.1-2.9 months of age) and one year later (11.5-16.1 months of age) for 430 infants participating in a prospective cohort study conducted between 2017 and 2019. Potential predictors were collected at enrollment or were measured during the year of the study. We performed a two-stage risk factor analysis, using univariate regression modeling to identify potential risk factors, followed by multivariable regression modeling to identify independent, significant risk factors for smaller OFC at birth and 1 year in this low resource setting. RESULTS: Mean OFC at enrollment was -0.4 (1.2) and at 1 year was -1.1 (0.9). Probable zika exposure in utero and shorter maternal height were independently, significantly associated with smaller OFC at both enrollment and 1 year. Exposure to cigarette smoking in utero was independently significantly associated with smaller OFC at enrollment. Infant complications at birth, microcephaly at enrollment and stunting at enrollment were also independently significantly associated with smaller OFC at 1 year (all p-values < 0.05). No exposures measured during the study were associated with OFC at 1 year. CONCLUSIONS: All the independent predictors of small OFC during the study period were present at enrollment (within the first 3 months of life), including maternal height, and smoking and ZIKV exposure during pregnancy. Exposures after the first three months of life were not predictive of OFC at one year. Continued work to identify specific risk factors and develop targeted prevention programs is warranted.
Maternal Smoking During Pregnancy and Adverse Childhood Experiences: The Role of Socioeconomic Status in Adulthood and Perinatal Abuse.
Da Rosa P, Stullich A, Richter M
Matern Child Health J · 2025 Sep · PMID 40682605 · Full text
OBJECTIVES: Previous research has linked adverse childhood experiences (ACEs) to maternal smoking, but the role of socioeconomic status (SES) in adulthood and perinatal abuse remains unclear. This study examined the stre...
OBJECTIVES: Previous research has linked adverse childhood experiences (ACEs) to maternal smoking, but the role of socioeconomic status (SES) in adulthood and perinatal abuse remains unclear. This study examined the strength of the association between ACEs and maternal smoking behaviors before, during, and after pregnancy and investigated whether maternal SES and perinatal abuse modify this association. METHODS: This cross-sectional study used data from the Pregnancy Risk Assessment Monitoring System survey (2017-2020). The weighted prevalence of self-reported ACEs and smoking was calculated. Multivariate logistic regression models were conducted to examine the association between ACEs and maternal smoking throughout pregnancy, accounting for maternal SES and perinatal abuse. RESULTS: Of the 6,595 respondents, nearly 20% of mothers reported experiencing one ACEs, while 29.3% reported three or more. Smoking prevalence was significantly higher among those with ACEs: 2.3% (95% CI 1.7%-3.2%) for mothers reporting zero ACEs, compared to 18.7% (95% CI 16.7%-20.8%) for those reporting three or more ACEs. While SES and perinatal abuse partially explained the association, women with three or more ACEs still had over four times the odds of smoking during pregnancy (aOR = 4.84, 95% CI 3.29-7.10), even after full adjustment. CONCLUSIONS: These results highlight the long-lasting consequences of adversities encountered in early life, which can shape the smoking behaviors of women even during the critical stages of their own pregnancy. There is a need for tobacco control interventions among the most vulnerable that extend beyond the traditional services and address deeply rooted factors from past experiences.
Feelings Matter: Predicting Postpartum Depression Symptoms from Pregnancy Planning and Emotional Reaction to Pregnancy.
Walsh EK, Langdon SW
Matern Child Health J · 2025 Oct · PMID 40682604 · Publisher ↗
INTRODUCTION: Both emotional reaction to pregnancy and pregnancy intention have been independently found to predict postpartum depressive symptoms (PDS). However, while pregnancy intention has been widely studied, there...
INTRODUCTION: Both emotional reaction to pregnancy and pregnancy intention have been independently found to predict postpartum depressive symptoms (PDS). However, while pregnancy intention has been widely studied, there is minimal research on emotional reaction to pregnancy, and even less research on how these two factors interact. METHODS: Data from the 2016-2021 Pregnancy Risk Assessment Monitoring System (PRAMS) survey in the state of Maine were analyzed for this study. Weighted logistic regressions were performed to predict both PDS and negative emotional reactions to pregnancy, with Odds Ratios and 95% Confidence Intervals calculated. RESULTS: Of 4,520 respondents, 38.8% reported unplanned pregnancies, 5.7% reported negative initial emotional reactions to pregnancy, and 4.2% reported unplanned pregnancies and negative initial emotional reactions. Approximately 11% reported PDS, and 15.1% had unplanned pregnancies and PDS, while 9% had planned pregnancies and PDS. Individuals with unplanned pregnancies had higher PDS risk than individuals with planned pregnancies, individuals with negative or unsure reactions had higher PDS risk than those with positive reactions, and individuals with unplanned pregnancies and all emotional reactions had increased PDS risk compared to those with planned pregnancies and positive reactions. After adjusting for covariates, only those indicating negative initial emotional reactions (independently) and those indicating negative emotional reactions and unplanned pregnancy (interactively) were at greater risk for PDS. Predictors of negative emotional reactions to pregnancy included lower income, greater number of previous live births, depression diagnosis in the 3 months before pregnancy, intimate partner abuse, and unplanned pregnancy. DISCUSSION: Negative emotional reaction to pregnancy and unplanned pregnancy independently and interactively predicted PDS. Findings highlight the importance of considering emotional and sociodemographic factors when evaluating the relationship between unplanned pregnancy and PDS.
Predisposing, Enabling, and Need Factors Associated with Postpartum Depression Treatment Among Women Enrolled in Texas Medicaid.
Pennington EL, Barner JC, Brown CM … +2 more , Moczygemba LR, Patel DA
Matern Child Health J · 2025 Nov · PMID 40676340 · Publisher ↗
OBJECTIVES: To determine which of the available predisposing, enabling, and need factors are related to receipt of postpartum depression (PPD) treatment among postpartum women with Texas Medicaid. METHODS: This retrospec...
OBJECTIVES: To determine which of the available predisposing, enabling, and need factors are related to receipt of postpartum depression (PPD) treatment among postpartum women with Texas Medicaid. METHODS: This retrospective database analysis used Texas Medicaid claims (1/1/2018-6/30/2022) and included women 12-55 years, continuously enrolled 84 days pre- to 12 months post-delivery, with a PPD diagnosis. The outcome was receipt of PPD treatment (psychotherapy and/or antidepressant medication) within 12 months post-delivery. Independent variables were guided by the Andersen Behavioral Model and included predisposing (age, race/ethnicity), enabling (urbanicity, prenatal care), and need (depression/anxiety, substance use disorder [SUD], cesarean delivery, preterm birth, pregnancy complications) factors. Multivariable logistic regression was used. RESULTS: Included women (N = 25,976) were 26.7 ± 5.9 years and 42.1% were Hispanic. Most women resided in urban counties (80.6%) and had 6.2 ± 3.4 prenatal visits, 3.3 ± 2.8 postpartum visits, and 1.4 ± 0.9 pregnancy complications. Nearly half (44.7%) had baseline depression/anxiety, 17.4% had baseline SUD, 35.8% had cesarean delivery, and 13.5% had preterm birth. Approximately, three-fourths (76.2%) received treatment within 12 months after delivery. Logistic regression (p < 0.0001) revealed that the likelihood of treatment receipt was significantly associated with age (25-29:odds ratio [OR] = 1.155, 95% confidence interval 1.039-1.284, 30-34: OR = 1.186;1.058-1.330, > 34: OR = 1.295;1.134-1.479; reference:<20), race (White: OR = 1.700;1.556-1.857; Hispanic: OR = 1.179;1.087-1.277; reference: Black), urbanicity (OR = 0.869;0.799-0.944), prenatal care (4-6 visits: OR = 1.178;1.039-1.336, 7-9 visits: OR = 1.156;1.020-1.311, > 9 visits: OR = 1.406;1.217-1.625; reference:0 visits), and cesarean delivery (OR = 1.099;1.031-1.173). CONCLUSIONS FOR PRACTICE: While over 75% of women with PPD received treatment, additional efforts to mitigate disparate consequences of untreated PPD should be focused on younger, Black, and urban women.
COVID-19 Disruption and Maternal and Child Health Services: Evidence from India.
Dongre A, Surana M
Matern Child Health J · 2025 Sep · PMID 40668326 · Publisher ↗
OBJECTIVES: To analyze the impact of COVID-19 and subsequent lockdowns on maternal and child health services in India and investigate whether certain population groups that are disadvantaged along social, economic and ge...
OBJECTIVES: To analyze the impact of COVID-19 and subsequent lockdowns on maternal and child health services in India and investigate whether certain population groups that are disadvantaged along social, economic and geographical dimensions experienced differential impacts. METHODS: Utilizing an unintended disruption in the fifth round of the National Family Health Survey (NFHS V) due to nationwide COVID-19 related lockdown, we create a sample of children and mothers who were 'exposed' to COVID-19 pandemic and lockdowns, and those who were not 'exposed'. We use multivariable regression to examine whether and to what extent antenatal care, pregnancy and post-pregnancy care of the 'exposed' mothers and children were adversely impacted as compared to those who were 'unexposed'. RESULTS: The 'exposed' mothers were less likely to receive two tetanus injections, and iron folic acid tablets during pregnancy, and were less likely to stay in medical facility for 48 hours post-delivery as recommended by the government guidelines. More critically, 'exposed' children had lower probability of receiving immunizations due at birth, 6-weeks, 10-weeks, and 14-weeks, with the magnitude of decline increasing for successive immunizations. The impacts were even more adverse in rural areas as reflected in heterogeneity analysis. CONCLUSIONS: COVID-19 pandemic and lockdowns adversely affected MCH services in India, and even more so in rural India. Policy interventions targeted specifically at groups who were impacted would be needed to restore MCH services to pre-pandemic levels. CLINICAL TRIAL REGISTRATION: Not Applicable.
Regulating the Midwife: Power, Public Health, and the Decline of Traditional Midwifery in West Virginia, 1881-1929.
De Ver Dye T
Matern Child Health J · 2025 Aug · PMID 40665090 · Publisher ↗
This historical policy analysis centers on how early maternal and child health (MCH) efforts affected the practice and decline of traditional midwifery in West Virginia. From the emergence of official government action i...
This historical policy analysis centers on how early maternal and child health (MCH) efforts affected the practice and decline of traditional midwifery in West Virginia. From the emergence of official government action in MCH with the establishment of the West Virginia Board of Health in 1881, through the federal Sheppard-Towner Maternity and Infancy Act of the 1920s-the nation's first large-scale attempt at making the provision and improvement of MCH issues a national priority-West Virginia transformed childbirth practices by increasingly regulating, professionalizing, and ultimately marginalizing traditional midwives. As the West Virginia case shows, the intersection of state and federal public policy and professional power attempted to improve maternal and infant outcomes, which often led to policies reducing autonomy and numbers of midwives. The West Virginia experience reflects wider US trends in the early twentieth century, showing that public health programs and physician-led campaigns combined to reform who was authorized to attend births. West Virginia's history exemplifies the dual nature of MCH legislation in the early 1900s, bringing much-needed resources and attention to maternal and infant health, but accelerating the decline of midwifery through regulatory oversight and the medicalization of birth, frequently leaving communities without skilled expertise in pregnancy-related care.
The Determinants of Influenza Vaccine Uptake in Pregnant Women During the COVID-19 Pandemic Using the Theory of Planned Behavior: A Cross-Sectional Study.
Kim B, Lee K, Kim E
Matern Child Health J · 2025 Sep · PMID 40658177 · Publisher ↗
Among pregnant women, influenza increases the risk of complications such as hospitalization, intensive care unit admission, and death. To prepare for new pandemics in the future, pregnant women's perceptions of influenza...
Among pregnant women, influenza increases the risk of complications such as hospitalization, intensive care unit admission, and death. To prepare for new pandemics in the future, pregnant women's perceptions of influenza vaccines during the COVID-19 pandemic should be investigated. This study used the theory of planned behavior (TPB) to identify the determinants of pregnant women's intention to receive the influenza vaccine and their uptake of it during the COVID-19 pandemic. A cross-sectional study was conducted among pregnant or postpartum women within one year of delivery from the largest online panel (n = 351). Data were collected using an online survey during April 1-15, 2022. Path analysis was performed to investigate the pathways of the TPB constructs' effects on influenza vaccine uptake. The influenza vaccination rate among pregnant women during the pandemic was 51%. Attitude towards vaccine (β = 0.60, p < 0.001) and subjective norms (β = 0.28, p < 0.001) directly and positively affected intention, which directly and positively affected uptake (β = 0.48, p < 0.001). Attitude towards vaccine (β = 0.29, p = 0.006) and subjective norms (β = 0.134, p = 0.015) also positively and indirectly affected uptake. Influenza vaccine uptake remains suboptimal among pregnant women in many countries. Attitude towards vaccine is the strongest determinant of the intention to receive the vaccine and its uptake during pregnancy. More active efforts are required to improve pregnant women's attitudes toward the vaccine.
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 40650844 · Publisher ↗
OBJECTIVES: To explore the impacts of a mobile health intervention on weight control, pregnancy outcomes, and health-promoting lifestyle profiles among overweight pregnant women. METHODS: A longitudinal, repeated-measure...
OBJECTIVES: To explore the impacts of a mobile health intervention on weight control, pregnancy outcomes, and health-promoting lifestyle profiles among overweight pregnant women. METHODS: A longitudinal, repeated-measures, randomized controlled trial. We enrolling 112 pregnant women classified as overweight pre-pregnancy. The intervention group received mobile-based health education for mom and baby (mHEMB) intervention for 6–8 months, whereas the control group received usual care. Women in both groups filled out a questionnaire to provide demographic and health information at time 1 (prior to 20 weeks of gestation). Body weight and health-promoting lifestyle profiles were assessed at time 1, time 2 (36–40 weeks of gestation), and time 3 (6–12 weeks postpartum). Maternal and neonatal outcomes were assessed at the time of delivery. RESULTS: Intervention participants gained less weight during pregnancy. The postpartum weight gain in the intervention group was significantly lower than that in the control group. The proportion of women who exceeded Institute of Medicine guidelines was significantly smaller in the intervention group than in the control group. With the exception of stress management, the scores for the health-promoting lifestyle profiles in the intervention group were significantly higher than those in the control group at time 2. No significant differences were noted in the health-promoting lifestyle profiles between the two groups at time 3. CONCLUSIONS FOR PRACTICE: The mHEMB provides pregnant women with the necessary skills and support to adopt long-term behavioral changes, with significant effects on weight control during pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov NCT03726983.
Nipple Pain and its Characteristics During the Breastfeeding Process: A Longitudinal Brazilian Study.
Ruiz MT, Pereira Melo BC, Resende CV … +5 more , Ferreira MG, Cavalcanti MC, da Silva JA, Christoffel MM, da Conceição Rodrigues E
Matern Child Health J · 2025 Sep · PMID 40650843 · Publisher ↗
OBJECTIVE: To characterize pain and its evolution during the breastfeeding process among primiparous women. METHOD: Longitudinal study nested within a clinical trial with 102 Brazilian primiparous women, with conditions...
OBJECTIVE: To characterize pain and its evolution during the breastfeeding process among primiparous women. METHOD: Longitudinal study nested within a clinical trial with 102 Brazilian primiparous women, with conditions and intentions favorable to breastfeeding. Pain level was measured using the Visual Analogue Scale and the descriptors, according to McGill. Follow-up was carried out via telephone in the first and second weeks postpartum. Failure to contact within 15 days was considered a loss. Fisher's exact test was applied to evaluate the association between the occurrence of pain and exclusive breastfeeding rates, and to evaluate the evolution of pain over the period, repeated measures ANOVA and Sidak's posthoc were applied. Values of p ≤ 0.05 were considered significant. RESULTS: Most participants reported moderate-intensity pain more frequently at the beginning of breastfeeding. The pain was classified as sensory and commonly described as 'pulling.' Notably, the study found pain scores, severe pain scores, and pain sensation descriptors reduced from hospitalization to two weeks after birth (p < 0.001). The study also found that pain in the second week postpartum was associated with lower rates of exclusive breastfeeding (p = 0.017), highlighting the need for early intervention and support to ensure successful breastfeeding. CONCLUSION: The study revealed nipple pain scores and qualifiers, its sensation during the breastfeeding process, and its evolution. Assessment and support in cases of this complaint are recommended.
The Impact of Cognitive-Behavioral Stress Management Training on Infertility-Related Stress in Couples: A Randomized Controlled Trial.
Chehreh R, Mohammadnejad S, Karamelahi Z … +1 more , Nasiri M
Matern Child Health J · 2025 Sep · PMID 40650842 · Publisher ↗
BACKGROUND: Infertility poses a significant emotional burden on couples, leading to increased stress levels. This study aimed to investigate the effectiveness of cognitive-behavioral stress management training in reducin...
BACKGROUND: Infertility poses a significant emotional burden on couples, leading to increased stress levels. This study aimed to investigate the effectiveness of cognitive-behavioral stress management training in reducing infertility-related stress among infertile couples. METHODS: A randomized clinical trial was conducted involving 20 infertile couples (40 individuals) who sought treatment at the Saboohi Infertility Center of Mahdieh in Tehran, Iran, between May and June 2018. Participants were selected using convenience sampling and randomly assigned to either the control group, which received routine infertility counseling, or the intervention group, which received cognitive-behavioral stress management training in addition to routine counseling. Independent t-tests and analysis of covariance (ANCOVA) were used. RESULTS: In the post-time period, the intervention group demonstrated a significant decrease in total stress scores compared to the control group for both men (B = - 15.07, p < 0.001) and women (B = - 2.82, p = 0.003), controlling for pre-time values. Subscale analyses revealed that the intervention group had lower scores in social concern, sexual concern, communication concern, rejection of childfree lifestyle, and the need to be a parent compared to the control group, for both men and women (p < 0.001). CONCLUSIONS: In conclusion, our study highlights the effectiveness of a behavioral-based stress management intervention alongside infertility counseling in controlling infertility-related stress. These findings support the inclusion of this comprehensive counseling approach in the care package for infertile couples, enabling healthcare professionals to reduce stress and improve overall well-being.
Heavy Metal Levels in Maternal Blood and Breast Milk and Associated Risk Factors.
Kaymak D, Atakol O, Acar N … +3 more , Öz S, Fındık RB, Tekin ÖM
Matern Child Health J · 2025 Jul · PMID 40650841 · Publisher ↗
OBJECTIVES: This study aimed to determine the concentrations of selected toxic metals in maternal blood and colostrum and to investigate their associations with environmental, lifestyle, and obstetric factors in postpart...
OBJECTIVES: This study aimed to determine the concentrations of selected toxic metals in maternal blood and colostrum and to investigate their associations with environmental, lifestyle, and obstetric factors in postpartum women. METHODS: In this prospective observational study, 95 postpartum women who had delivered at term without any chronic or pregnancy-related comorbidities were included. Venous blood samples were collected from the antecubital vein, and approximately five to ten milliliters of colostrum were obtained from both breasts following breastfeeding within forty-eight hours after delivery. Maternal demographic characteristics, environmental exposures, supplement use, and neonatal outcomes were recorded using structured questionnaires. Metal concentrations were measured using atomic absorption spectrometry. RESULTS: Nickel concentrations were significantly higher in the blood of participants who used stoves for home heating, while cadmium levels were elevated in those consuming spring or tap water (p < 0.05). Participants residing in metropolitan areas had significantly lower iron levels in blood compared to those in rural areas (p < 0.05). Women with hemoglobin levels below eleven grams per deciliter showed elevated nickel levels in blood. Blood concentrations of nickel and cobalt were significantly lower among women who used fish oil or vitamin supplements, respectively (p < 0.05). A significant inverse correlation was observed between blood levels of nickel, cobalt, manganese, and lead and iron concentrations in colostrum (p < 0.05). In addition, iron concentrations in colostrum were significantly lower in neonates with a 1-minute Apgar score of ≤ 7 compared to those with higher scores (p = 0.008). CONCLUSION: Environmental exposures and maternal nutritional status significantly influence metal concentrations in blood and colostrum. In particular, iron deficiency and suboptimal perinatal outcomes may increase susceptibility to heavy metal accumulation, underscoring the importance of comprehensive prenatal care and environmental risk assessment during pregnancy.
Maternal and Neonatal Outcomes in Pregnancies with Adenomyosis.
Hguig S, Czuzoj-Shulman N, Spence AR … +1 more , Abenhaim HA
Matern Child Health J · 2025 Sep · PMID 40634714 · Publisher ↗
OBJECTIVES: Adenomyosis is a common gynecologic disease involving the uterus, with its effect on pregnancy being poorly understood. This study aimed to evaluate the associations between adenomyosis and obstetrical and ne...
OBJECTIVES: Adenomyosis is a common gynecologic disease involving the uterus, with its effect on pregnancy being poorly understood. This study aimed to evaluate the associations between adenomyosis and obstetrical and newborn outcomes. METHODS: Using the Healthcare Cost and Utilization Project-National Inpatient Sample from the United States, we conducted a retrospective cohort study of all birth-related admissions from 2016 to 2019. Pregnancies with adenomyosis were identified using the ICD-10 code N80.03, with the remaining pregnancies being the reference group. Then, ICD-10 codes were used to identify obstetrical and neonatal outcomes and multivariable logistic regression models, adjusted for baseline maternal demographics, were used to determine the impact of adenomyosis on these outcomes. Also, in light of the potential detection bias inherent in births by cesarean delivery, adjustment for mode of delivery was included in all regression analyses. RESULTS: Among the 2,943,532 women who delivered between 2016 and 2019, 1,084 had adenomyosis, for an overall prevalence of 36 cases/100,000 births, which was stable throughout the study period. Adenomyosis in pregnancy was associated with increased frequency of placenta abruptio (adjusted OR 1.7, 95% CI 1.2-2.4), preterm delivery (1.4, 1.2-1.6), preterm premature rupture of membranes (1.3, 1.1-1.6), postpartum hemorrhage (2.7, 2.1-3.3), post-partum transfusion (2.2, 1.6-3.0), disseminated intravascular coagulation (9.3, 4.2-20.9), sepsis (2.7, 1.6-4.5), congenital anomalies (2.0, 1.3-2.8), and intrauterine fetal demise (2.0, 1.0-3.8). Also, these pregnancies had an elevated risk of delivering by cesarean (15.7, 12.7-19.3). CONCLUSION: Adenomyosis in pregnancy is associated with adverse obstetric and fetal outcomes. As such, pregnancies in patients with adenomyosis should be considered high-risk and should be delivered in centers capable of managing the potential poor events associated with these pregnancies.
Exploring Severe Fear of Childbirth in China: An In-depth Systematic Review of Prevalence, Risk Factors, and Interventions.
Chen C, Hussein SZ, Isa ZM … +6 more , Nasri NWM, Yao J, Qin Y, Duan C, Bian Y, Hao R
Matern Child Health J · 2025 Sep · PMID 40634713 · Publisher ↗
OBJECTIVES: Fear of childbirth (FOC) is a psychological symptom, prevalent among pregnant women, which negatively impacts women's health and well-being. The objective of this study is to analyze existing literature regar...
OBJECTIVES: Fear of childbirth (FOC) is a psychological symptom, prevalent among pregnant women, which negatively impacts women's health and well-being. The objective of this study is to analyze existing literature regarding pregnant women in China, evaluating the prevalence, risk elements, and interventions to alleviate severe childbirth fear. METHODS: A comprehensive search was done across nine bibliographic databases to retrieve published research from their earliest records to August 2023. The Joanna Briggs Institute (JBI) Critical Appraisal instruments were employed to evaluate the quality of each article. Data were independently extracted by pairs of reviewers and synthesized through a narrative analysis. RESULTS: The review comprised ten studies: seven cross-sectional studies and three randomized controlled trials. The results revealed varied prevalence rates of FOC. Risk factors identified were categorized into three main groups: sociodemographic characteristics, pregnancy and birth-related aspects, and mood-related aspects. Identified interventions included relaxation therapy and cognitive behavioral therapy. CONCLUSIONS: Studies are scarce concerning FOC among Chinese pregnant women. However, existing research indicates that FOC remains prevalent within the population. Moreover, these studies reveal that risk factors for this fear are multifaceted, and limited intervention approaches are available. This study highlights the urgent need for further research to deepen the understanding of FOC among Chinese women and develop more comprehensive and tailored interventions to improve the overall maternal health and childbirth experiences in China.
Assessing the Impact of Social Factors on Survival Among Infants Born with Transposition of the Great Arteries, Tetralogy of Fallot, and Diaphragmatic Hernia in Texas, 2011-2019.
Betancourt D, Shumate C, Canfield MA … +5 more , Ferdinand A, Page R, Morris T, Ayres S, Sinha S
Matern Child Health J · 2025 Sep · PMID 40632420 · Publisher ↗
INTRODUCTION: Social factors impact survival for infants with birth defects. This analysis describes the impact of social factors on one-year survival for infants with congenital diaphragmatic hernia (CDH), transposition...
INTRODUCTION: Social factors impact survival for infants with birth defects. This analysis describes the impact of social factors on one-year survival for infants with congenital diaphragmatic hernia (CDH), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF). METHODS: Survival estimates were generated using the Kaplan-Meier method and the log-rank test with 0.05 significance stratified by social factors for infants born 2011-2019 with CDH (N = 942), TGA (N = 1,102), or TOF (N = 1,545). Crude hazard ratios (HR) and adjusted hazard ratios (AHR) with 95% confidence intervals (CI) were calculated for infant death using the Cox proportional hazards models. RESULTS: One-year survival was 88.7% for TOF, 88.0% for TGA, and 72.7% for CDH. Infants with CDH whose mother resided along the Texas-Mexico border had an increased risk of death compared to non-border residents (HR = 1.68, p =.003). Lower maternal education attainment was associated with increased risk of death for infants with TGA (HR = 1.75, p =.002) or TOF (HR = 1.54, p =.005) compared to infants whose mother had more than a high school education. Maternal Hispanic ethnicity increased the risk of death for infants with TGA (HR = 1.75, p =.005) or TOF (HR = 1.74, p =.002) compared to NH White infants. DISCUSSION: Hispanic maternal ethnicity, lower maternal educational attainment, and residence along the Texas-Mexico border negatively impact infant one-year survival.
Language-Based Inequities in Transfusion Practices with Obstetric Hemorrhage.
Cohen A, Goulding S, Pickett C … +5 more , Lynch B, Obanor O, Peskin-Stolze M, Dar P, Doulaveris G
Matern Child Health J · 2025 Jul · PMID 40627266 · Full text
OBJECTIVES: Inequities in race, ethnicity and socioeconomic status have been well documented in postpartum hemorrhage (PPH) and hemorrhage-associated morbidity. However, little is known about the impact of language barri...
OBJECTIVES: Inequities in race, ethnicity and socioeconomic status have been well documented in postpartum hemorrhage (PPH) and hemorrhage-associated morbidity. However, little is known about the impact of language barriers on maternal outcomes in PPH. Our study aim was to investigate language-based inequities in maternal outcomes among gravidas with PPH. METHODS: This is a retrospective cohort of patients with PPH who delivered at an urban academic institution between January 2020 and December 2022. Maternal language is categorized as English primary language (EPL) or non-English primary language (NEPL). PPH is defined as a quantitative blood loss (QBL) greater than 1000 mL within 24 h of delivery. QBL is a calculated measurement of peripartum and postpartum blood loss. Primary outcome is transfusion of packed red blood cells (pRBC). Secondary outcomes include transfusion of 4 + units of pRBC, disseminated intravascular coagulation (DIC) and admission to intensive care unit (ICU). Multivariable logistic regression was used to estimate the association of primary language with maternal outcomes. RESULTS: 1723 patients with PPH were included: 1314 (76.3%) with EPL and 409 (23.7%) with NEPL. English-speaking and non-English speaking patients had similar QBL rates (1530.2 ± 634.2 vs 1496.0 ± 668.1, p = 0.3). However, transfusion rates were lower in those with NEPL, when compared to EPL (28.2% vs 22.9%, p = 0.039). After adjusting for age, race/ethnicity, nulliparity, body mass index, pre-eclampsia and pre-delivery anemia, gravidas with NEPL were less likely to be transfused compared with EPL (aOR 0.7, 95% CI 1.012-1.806, p = 0.04). Rates of DIC, ICU admission and transfusion of 4 + units of pRBC were similar between groups. CONCLUSIONS FOR PRACTICE: Despite a similar postpartum blood loss, patients with NEPL had lower rates of blood transfusion in PPH compared to patients with EPL. Further research is needed in health literacy and language proficiency that may impede access to transfusion in patients with PPH.
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