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Biomedical subjects

E H Graham

Publications and source records attributed to E H Graham.

6 recordsLinked to original sources
PubMed1999

A unique drug treatment program for pregnant and postpartum substance-using women in New York City: results of a pilot project, 1990-1995.

In the 1980s, there was virtually no drug treatment for pregnant women in New York City, especially women who used crack cocaine. The purpose of the Parent and Child Enrichment (PACE) demonstration project was to assess the effectiveness of the one-stop shopping model of drug treatment for this population. Among PACE clients, 88% were primarily users of crack cocaine. The mean total length of stay was 100.0 days (median 55.5 days). Client retention 42 days after intake was 54.3%. This paper describes the essential components of this program model. "Long-stay" and "short-stay" clients were compared using urine toxicology tests and activity logs. In addition, the birth outcomes of clients were compared to two similar populations. A strong positive correlation was found between total length of stay and low rate of positive urine drug tests (UDTs). Infants of PACE long-stay clients had greater mean birth weight, less low birth weight, and less intrauterine growth retardation than the infants of the comparison groups. Fetal exposure to cocaine was decreased dramatically among women who were enrolled for 42 or more days during their pregnancy. This model of drug treatment for pregnant and postpartum women seems to improve mothers' lives, fetal drug exposure, and birth outcome significantly.

Child↗
PubMed1998

Breast-feeding initiation in New York City, 1979 to 1996.

OBJECTIVES: The purpose of this study was to explore changes in breast-feeding initiation from 1979 to 1996 among infants born in New York City hospitals. METHODS: All New York City hospitals were surveyed every 2 years. Hospital staff reported feeding method at newborn discharge. RESULTS: New York City breast-feeding initiation rates increased consistently from 1979 to 1996 (from 29% to 58%, P < .0001), including 1984 to 1990, when rates decreased nationally. CONCLUSIONS: A 1984 New York State regulation requiring each hospital to designate a lactation coordinator may have been associated with the continuing increases in breast-feeding initiation.

Breast Feeding↗
PubMed1995

Homicide and other injuries as causes of maternal death in New York City, 1987 through 1991.

OBJECTIVES: We attempted to document the role of homicide and other injuries as causes of maternal death and to compare the risk of fatal injury among pregnant women with that in the general population. STUDY DESIGN: We reviewed New York City medical examiner records of 2331 women aged 15 to 44 years who died of injury in 1987 through 1991. Pregnancies were identified from autopsy information. RESULTS: A total of 115 (39%) of 293 deaths in currently or recently pregnant women were attributable to injury. These 115 deaths included homicide (63%), suicide (13%), motor vehicle crashes (12%), and drug overdoses (7%). Minority women were overrepresented among the injury deaths (black 53%, Hispanic 24%, white 19%). Recent substance use was documented in 48% of the injury deaths. Pregnancy was documented on only 35% of the 115 death certificates. The risk of fatal injury is similar for currently pregnant women and for women in the general population, except for an increased risk of homicide among pregnant black women. CONCLUSIONS: Homicide and other injuries are major contributors to maternal mortality and should be (but rarely are) included routinely in maternal mortality surveillance systems. Prenatal and postpartum clinic visits represent an ideal time to implement interventions to prevent injuries among pregnant women.

Accidents, Traffic↗