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PubMedDate not supplied

The state of infant health and its relationship to maternal prenatal health in the United States.

The United States ranks behind 19 other industrialized nations in infant mortality. Despite this country's affluence and medical sophistication, Black infants in some U. S. cities have a higher infant mortality rate than infants in some Third World countries. This article examines the impact that maternal prenatal health, teenage pregnancy and strategies to reduce infant mortality have on the general health of infants. A comparison is made between the strategies used by the United States and those used by other industrialized nations who have been more successful in reducing their infant mortality rate.

Adolescent↗
PubMed2006

Parental literacy and infant health: an evidence-based healthy start intervention.

Syracuse Healthy Start, a federally funded infant mortality prevention project in Onondaga County, New York, has undertaken a range of interventions to address parental low literacy as a risk factor for infant mortality. A growing number of studies advocate for health-related information that is easy to read, of a low literacy level, and culturally appropriate. Creation of an evidence-based public health intervention involves analyzing local data, reviewing published studies, assessing available materials, initiating programmatic interventions, and evaluating the outcomes. Preparing health educational materials that are clear, culturally sensitive, and at appropriate reading levels follows Paulo Freire's lead in empowering the disadvantaged to positively affect their health and the health of their infants toward the reduction of infant mortality.

Educational Status↗
PubMed2006

Randomized controlled trial of a prenatal and postnatal lactation consultant intervention on infant health care use.

OBJECTIVE: To determine whether infants of women randomized to a prenatal and postpartum lactation support intervention incur fewer otitis media-, respiratory tract-, or gastrointestinal-related visits than controls. DESIGN: Randomized, unmasked controlled trial recruiting women from prenatal care settings. Breastfeeding sensitive (BFS) illness visits for otitis media or respiratory tract or gastrointestinal complaints were obtained up to 12 months. SETTING: Two urban community health centers. PARTICIPANTS: Analytic sample of 338 low-income, primarily Hispanic and/or black mother-infant dyads (n = 163 for the intervention group and n = 175 for the control group). INTERVENTION: Study lactation consultants attempted 2 prenatal meetings, 1 postpartum hospital and/or home visit, and telephone calls as needed. Controls received the standard of care. MAIN OUTCOME MEASURES: Combined outpatient and emergency department visits with illness and BFS illness diagnoses. RESULTS: There was a significant interaction between treatment and Medicaid; among those not receiving Medicaid, the number of otitis media visits was higher among controls (P</=.03). Visits for any illness and BFS, gastrointestinal, or respiratory tract illnesses did not differ by treatment group. Intervention group infants received more breast milk than controls, but exclusive breastfeeding rates remained low and did not differ between groups at any point. CONCLUSIONS: Only the number of otitis media visits was reduced, in a subset of the intervention group. The intervention did not reduce visits for respiratory tract or gastrointestinal illness. Limited intervention contact and low exclusive breastfeeding rates may have attenuated intervention effects. Future interventions designed to yield markedly increased breastfeeding rates may show greater effects in low-income multiethnic samples. Health coverage for visits may moderate intervention effects.

Black People↗
PubMed1982

Effect of urban versus rural residence and of maternal education on infant health in South Lebanon.

A sample of 253 women from rural and urban areas of south Lebanon were visited for 18 months after delivery. Information was collected on patterns of reproduction, infant feeding, and use of the health services. The findings indicate that educated women and women living in urban areas were better off in terms of family formation patterns, immunisation, and well-baby care. The importance of educating women, particularly in rural areas, as a policy that can be varied to improve child health and growth is thus emphasised. The study also indicates, however, the special need for health education programmes directed to all mothers to emphasise proper breast-feeding patterns and the importance of preventive health care for infants. The findings also indicate the need for a more diversified system of delivering health care in which properly trained paramedical personnel take part, particularly in rural areas.

Adult↗
PubMed1981

Follow-up of methadone-treated and untreated narcotic-dependent women and their infants: health, developmental, and social implications.

This study compares the first year's health, neurodevelopmental status, and environment of infants of drug-dependent mothers attending methadone programs during pregnancy with those of drug-dependent mothers not enrolled in treatment programs (untreated). Both groups were also compared with drug-free controls. During pregnancy, the use of heroin and other psychoactive drugs was common among patients using methadone. Neonatal abstinence syndrome was of longest duration in the methadone group. Infants of both drug groups were smaller at birth, had more neonatal infections, and were viewed as more difficult to care for after nursery discharge than were those of drug-free mothers. On follow-up, mean developmental scores were within the normal range for all groups. The untreated drug-dependent group was more hypertonic than the methadone group, and a high rate of transient or minor motor disturbances and poor attention span was found in both drug groups. The behavior of methadone-treated women during pregnancy and the postnatal period closely resembled that of drug-free controls, and contrasted with untreated drug-dependent women. Methadone-treated women had a high degree of compliance with antepartum care, and 80% continued in the role of parent through the first year. Further investigation will determine whether the consistency of parenting will continue and whether it will enhance the development of their children.

Adult↗
PubMed2004

Infant health of mothers with multiple sclerosis.

Controversy surrounds whether mothers with multiple sclerosis (MS) who wish to breast-feed their infants should forego breast-feeding in order to resume immunomodulating therapy following birth even though breast-feeding has not been shown to have deleterious effects on these mothers. Knowledge of potential health benefits to infants through breast-feeding could influence health care providers to encourage mothers with MS who wish to breast-feed to do so. This study of 140 breast-feeding and 35 non-breast-feeding mothers with MS identifies the type and prevalence of illnesses experienced by their infants during the first 6 postpartum months and at 9 months and 12 months. Significantly more non-breast-fed than breast-fed infants experienced otitis media, lower respiratory illness, constipation, milk intolerance, and allergy during the 1st year. Study results support the need to encourage mothers with MS who wish to breast-feed their infants to do so and to delay immunomodulating therapy until breast-feeding cessation.

Bottle Feeding↗
PubMed2006

Impact of infant health problems on postnatal depression: pilot study to evaluate a health visiting system.

This pilot study aimed to elucidate whether or not mothers who receive neonatal home visits tend to suffer from depressive disorders during the first postpartum year and to examine what kinds of factors were related to the postnatal depression observed in these mothers. The subjects consisted of 70 Japanese mothers who received neonatal home visits and completed the 1-year study. At their first visit, the health visitors asked about their personal backgrounds and early postpartum mood, and depression was assessed by a Japanese translation of the Edinburgh Postnatal Depression Scale (EPDS). At 12 months postpartum, a diagnostic interview using the Structured Clinical Interview for DSM-IV (SCID) was performed to confirm the maternal diagnosis by a psychiatrist. An assessment of infant development using the Denver Developmental Screening Test (DDST) was administered to each infant by a psychologist. Nineteen mothers (27%) were categorized as having had a new onset of depression (12 major depressive disorders and seven depressive disorders not otherwise specified). In comparison to the non-depressed mothers, infant-related health problems that required either outpatient treatment or hospitalization were significantly related to postnatal depression. Pediatric diseases in infants did not always precede their mother's depression. The extra burden of caring for a sick infant tends to increase the risk of developing postpartum depression. As a result, neonatal home visits by health visitors may therefore be a potentially crucial opportunity to provide emotional support, particularly for mothers with the extra burden of having to care for sick infants.

Adult↗
PubMedDate not supplied

Infant health consequences of childbearing by teenagers and older mothers.

The association of childbearing at early and late ages with various adverse outcomes of pregnancy was explored in data collected in the 1980 National Natality and Fetal Mortality Surveys. The characteristics of interest for teenage mothers were marital status at conception and the trimester of pregnancy in which prenatal care was begun. For married mothers aged 30 years and older, the variables considered were employment status and occupation during the year preceding childbirth and smoking status before and during pregnancy. The pregnancy outcome variables analyzed were the same for both groups of mothers: fetal loss, low birth weight, and low 1-minute Apgar scores. Although more than half of all births to teenage mothers were to unmarried women, an additional one-quarter of these births were to women who married between the time of conception and the birth of the child. Generally there was little difference in outcomes for teenage mothers who were married at the time of delivery, regardless of their marital status at the time of conception. Pregnancy outcomes for teenagers who did not marry prior to delivery were considerably less favorable. Nearly 90 percent of women aged 30-34 years who had a first birth in 1980 were employed during the year before delivery, an extraordinarily high labor force participation rate. More than half of these employed mothers were in professional occupations, consistent with their very high levels of educational attainment. Although the analysis is limited by the small numbers of births involved, it appears that professionally employed women generally have the best pregnancy outcomes. When mother's smoking status is taken into account,nonsmokers had more favorable outcomes, with births to professionally employed mothers generally most favored.

Adolescent↗
PubMed1993

Hypertension during pregnancy in Africa and infants' health. A cohort study in an urban setting.

The objective of the study was to assess the prevalence of unclassified hypertension during pregnancy and its consequences on infant's health in an African urban setting: Pikine, a suburb of Dakar, Senegal. A cross-sectional study of a random sample of pregnant women and a prospective study, from the inclusion to seven days after delivery, were performed. 886 women attending the prenatal centers were included in the cross-sectional study. 471 pregnant women were included in the follow-up study. The prevalence of DBP > or = 120 mmHg was 0.7%; 5.7% of the women had DBP > or = 95 mmHg. Longitudinal data were available for 425 deliveries. Two spontaneous abortions, 25 stillbirths, and 12 deaths during the early neonatal period were recorded. Among babies living at birth, the percentage of LBW (> or = 2500 g) was 8.5%. The percentages of adverse outcome of pregnancy (death and/or low birth weight) was associated with mothers' diastolic BP: < 85 mmHg: 13%; 85 to 89: 16%; 90 to 94: 9%; DBP > or = 95: 32%, (p < 0.01). Using 95 mmHg as a cutpoint, the relative risk of adverse outcome associated with a DBP > or = 95 mmHg was 2.5 (CI 95%: 1.4-4.3). This risk was significantly increased among women who reported difficult living conditions. Eight percent of the adverse outcomes of pregnancy, 10% of the low birth weights and 8% of the perinatal mortality were found to be associated with DBP > or 95 mmHg.

Adolescent↗
PubMed1990

Maternal-infant health care: a comparison between the United States and West Germany.

The health and well-being of mothers and infants are of world-wide concern. Although the United States spends more money on health care than most other countries, it continues to lag behind other countries in its infant mortality rate (IMR). The author's perusal of research reports and her work experience in a hospital maternity setting in both the United States and West Germany (before the recent unification) suggest that the United States could benefit by reviewing the experience of others. The author also describes several strategies used in Germany to reduce its IMR--practices that could be implemented in the United States.

Adolescent↗