Maternal and child health journal
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Matern Child Health J · Aug 2013
Maternal pre-gravid obesity and early childhood respiratory hospitalization: a population-based case-control study.
Inflammation in utero is linked to childhood respiratory and infectious complications. Obesity is an increasingly common chronic inflammatory state, yet little is known about its role in childhood respiratory illness. We sought to examine the association between maternal pre-gravid BMI and early childhood respiratory hospitalization. ⋯ An elevated maternal pre-gravid BMI was associated with increased risk of childhood respiratory hospitalization, with an adjusted odds ratio OR [95 % CI] = 1.08 [1.03-1.14] for overweight mothers (BMI 25-29.9 kg/m(2)), and OR = 1.29 [1.22-1.36] for obese mothers (BMI ≥ 30 kg/m(2)). An elevated maternal pre-gravid BMI was associated with higher risk of early childhood respiratory hospitalization. Childhood respiratory illness may be an important complication of excess maternal weight that should be shared with expectant mothers.
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Matern Child Health J · Aug 2013
Emergency obstetric referral in rural Sierra Leone: what can motorbike ambulances contribute? A mixed-methods study.
Giving birth remains a dangerous endeavour for many of the world's women. Progress to improve this has been slow in sub-Saharan Africa. The second delay, where transport infrastructure is key in allowing a woman to reach care, has been a relatively neglected field of study. ⋯ It is well known to the communities, is acceptable and accessible, and is valued by those it serves. District-wide traditional birth attendant training and the sensitisation activities provided a foundation for the introduction of the ambulance service, creating a high level of awareness of the service and its importance, particularly for women in labour. Motorbike ambulances are suited to remote areas and can function on poor roads inaccessible to other vehicles.
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Matern Child Health J · May 2013
Labor epidural anesthesia, obstetric factors and breastfeeding cessation.
Breastfeeding benefits both infant and maternal health. Use of epidural anesthesia during labor is increasingly common and may interfere with breastfeeding. Studies analyzing epidural anesthesia's association with breastfeeding outcomes show mixed results; many have methodological flaws. ⋯ In post hoc analyses stratified by Baby Friendly Hospital (BFH) status, epidural anesthesia significantly predicted breastfeeding cessation (BFH: 1.19 [1.01, 1.41], p < 0.04; non-BFH: 1.65 [1.31, 2.08], p < 0.01). A relationship between epidural anesthesia and breastfeeding was found but is complex and involves institutional, clinical, maternal and infant factors. These findings have implications for clinical care and hospital policies and point to the need for prospective studies.
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Matern Child Health J · Apr 2013
Severe acute maternal morbidity in a high-income developing multiethnic country.
With declining maternal mortality, the study of severe acute maternal morbidity (SAMM) provides an opportunity to measure the quality of maternal care and to identify ways to improve it. The objective was to study the epidemiology of severe acute maternal morbidity in a high income, rapidly developing, multiethnic country in the Middle East, and to determine the role of ethnicity in maternal morbidity. We included all births occurring in maternal units with more than 500 births a year over a 6 year period in Abu Dhabi emirate, the largest province of the United Arab Emirates. ⋯ Preeclampsia was significantly higher in women from the Indian sub-continent and hemorrhage was more prevalent in UAE women. We have shown that it is possible to use a clinical criteria based approach to study the epidemiology of SAMM. The leading contributors to SAMM were hypertensive disorders and hemorrhage with clear ethnic links supporting earlier reports of a complex interaction between ethnicity, socioeconomic status and maternal health.
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Matern Child Health J · Apr 2013
Language and immigrant status effects on disparities in Hispanic children's health status and access to health care.
The objective of this study is to estimate Hispanic/non-Hispanic (nH)-white health disparities and assess the extent to which disparities can be explained by immigrant status and household primary language. The 2007 National Survey of Children's Health was funded by the Maternal and Child Health Bureau, and conducted by Centers for Disease Control and Prevention's National Center for Health Statistics as a module of the State and Local Area Integrated Telephone Survey. ⋯ English-speaking and nonimmigrant Hispanic children are more similar to nH-white children than are Hispanic children in non-English speaking households or immigrant children. Hispanic/nH-white health disparities among children are largely driven by that portion of the Hispanic population that is either newly-arrived to this country or does not speak primarily English in the household.