Maternal and child health journal
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Matern Child Health J · Sep 2005
Comparative StudyVariations in the incidence of postpartum hemorrhage across hospitals in California.
Because postpartum hemorrhage may result from factors related to obstetrical practice patterns, we examined the variability of postpartum hemorrhage and related risk factors (obstetrical trauma, chorioamnionitis, and protracted labor) across hospital types and hospitals in California. ⋯ The incidence of postpartum hemorrhage and related risk factors varied substantially across hospital types and hospitals in California. Further studies using primary data sources are needed to determine whether these variations are related to the processes of care.
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Matern Child Health J · Sep 2005
Factors associated with intention to breastfeed among low-income, inner-city pregnant women.
To examine the relationship between sociodemographic factors, maternal characteristics, and intention to breastfeed among low-income, inner-city pregnant women. ⋯ Significant differences were documented in breastfeeding intention in our sample of low-income, inner-city women. Most notable was the higher likelihood of anticipated breastfeeding among our immigrant sub-groups when compared with non-Hispanic white women. An unexpected finding was the higher likelihood of anticipated breastfeeding among native-born, non-Hispanic African American women than among non-Hispanic white respondents. Because intentions are important predictors of future behavior, more focus needs to be directed towards breastfeeding promotion during the prenatal period and towards a better understanding of why some mothers intend to breastfeed while others do not.
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Matern Child Health J · Dec 2004
Comparative StudyThe relation of FIMR programs and other perinatal systems initiatives with maternal and child health activities in the community.
To evaluate the association of the presence of a fetal and infant mortality review (FIMR) program, other perinatal systems initiative (PSI), or both in a community with the performance of essential maternal and child health (MCH) services by local health departments (LHDs). ⋯ Local health departments in communities with FIMR programs or PSIs appear to be more likely to conduct essential MCH services in the community. Some of these relations are unique to FIMR, particularly for data collection and quality assurance services, and some are unique to PSIs, for example those that involve interaction with other community agencies or groups. Performance of the essential MCH services also appears to be enhanced when both a FIMR program and a PSI are present in the community.
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Matern Child Health J · Mar 2003
Comparative StudyDifferences in use of health services between White and African American children enrolled in Medicaid in North Carolina.
Racial differences in health status and use of health services persist in the United States and are not completely explained by differences in socioeconomic status. This study examines differences in use of health services between White and African American children enrolled in Medicaid, controlling for other factors that affect service use. We make comparisons for use of primary preventive services, diagnosis and treatment of selected common childhood illnesses, and Medicaid expenditures. ⋯ African American children enrolled in Medicaid use health services much less than White children, even when controlling for socioeconomic status and other factors that affect service use. Linking state administrative databases can be a cost-effective way of addressing important issues such as racial disparities in health service use.
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Maternal mortality ratios in the United States are higher than those of many other industrialized nations. Moreover, these ratios have not changed in the past 20 years, and large racial disparities persist in measures of both maternal mortality and morbidity. In an affluent developed country, maternal deaths should serve as rare sentinel events, highlighting opportunities for prevention and reduction of morbidities. However, existing surveillance efforts are poorly developed, and pregnancy-related deaths and illnesses tend to be underreported. To formulate recommendations for improved surveillance, the authors reviewed existing data on maternal health. ⋯ Maternal health remains an important frontier for U.S. public health surveillance efforts. Improved surveillance offers opportunities for reducing pregnancy-related mortality and gaining a better understanding of the relationship between maternal morbidity and mortality.