Maternal and Child Health Journal最新文献

Introduction: Malnutrition in early childhood has long-term health consequences, including increased obesity risk due to catch-up growth in undernourished infants. While maternal perceptions and feeding practices affect infant malnutrition, limited evidence exists in middle-income countries like Mexico. This study examines the associations between maternal perceptions, feeding practices, and nutritional status in infants aged 6-12 months in northeastern Mexico.

Methods: A total of 192 mother-infant dyads were assed using questionnaires and anthropometric measurements. Maternal variables included perception of hunger and satiety, infant weight perception, feeding attitudes, self-efficacy, fatigue, and feeding practices. Infant nutritional status was determined using WHO Anthro, and multiple logistic regression identified associations between maternal and infant factors and nutritional status.

Results: 38% of infants were overweight/obese, and 7% were underweight. Low maternal self-efficacy, low perception of hunger and satiety signs, non-recommended feeding attitudes, and inaccurate perception of infant weight were identified. Maternal nocturnal sleep hours, type of feeding, and feeding frequency were associated to underweight. The maternal perception of infant weight was inaccurate for both underweight (mothers overestimate the weight) and overweight/obese (mothers underestimate the weight) infants.

Discussion: The main maternal perception influencing infant nutritional status was inaccurate weight perception. Mothers demonstrated limited knowledge and negative feeding practices with non-recommended feeding practices among Mexican mothers. Longer maternal sleep duration (> 8 h/night) was associated with underweight infants.

Introduction: The United States is the only high-income country without a comprehensive national maternity leave policy guaranteeing paid, job-projected leave. The current study examined associations between maternity leave characteristics (duration of leave, payment status of leave) and postpartum depressive symptoms.

Methods: This study used a sample of 3,515 postpartum women from the New York City and New York State Pregnancy Risk Assessment Monitoring System (PRAMS) from 2016 to 2019. We used logistic regression to examine the association of leave duration and payment status with self-reported postpartum depressive symptoms between 2 and 6 months postpartum.

Results: Compared to having at least some paid leave, having unpaid leave was associated with an increased odds of postpartum depressive symptoms, adjusting for leave duration and selected covariates (adjusted odds ratio [aOR] = 1.41, 95% confidence interval [CI]: 1.04-1.93). There was no significant difference in postpartum depressive symptoms between those with partially and those with fully paid leave. In contrast to prior literature, leave duration was not significantly associated with postpartum depressive symptoms (aOR = 0.99, 95% CI: 0.97-1.02 for each additional week of leave).

Discussion: This study suggests that unpaid leave is associated with increased risk of postpartum depression, which can have long-term health effects for both mothers and children. Future studies can help to identify which communities could most benefit from paid leave and help to inform paid leave policies.

Objectives: This study describes the development, acceptability, and implementation of an interactive text messaging program to engage fathers enrolled in home visitation programs.

Methods: We used an iterative development approach that integrated rapid testing of intervention content with acceptability feedback from program participants to examine the processes of implementation. In Study 1, we describe the rapid testing framework and present data from 171 men who provided feedback on Text4Dad content via three online surveys. In Study 2, a case study, we use administrative data from 108 fathers with whom we pilot-tested Text4Dad in three community-based home visiting programs, with the program implemented by fatherhood program community health workers (F-CHWs). Content analysis of exchanges between F-CHWs and fathers describes the specific use of Text4Dad.

Results: Across all three online surveys, fathers reported positive reviews of the Text4Dad content. The F-CHWs used Text4Dad mainly to push out information, especially that related to home visit scheduling and local events, instead of engaging in bidirectional interactions with fathers.

Conclusions for practice: We conclude with a set of recommendations for social service and maternal and child health providers regarding the feasibility of implementing text messaging to support home visiting in community-based settings.

Children and youth with special health care needs have increasingly been included in community and society over the past 50 years. Changing definitions and programs in the education, health, and public health/Title V sectors document this greater inclusion. The most profound change was in the education system, with the passage of legislative mandates for inclusion and parental rights. Although the health system has no similar universal mandate, the sequential passage of Medicaid, Children's Health Insurance Plan, and the Patient Protection and Affordable Care Act led to expanded health care coverage with no pre-existing conditions and lifetime caps. Title V of the Social Security Act, originally passed in 1935, evolved from a focus on individual medical services to a public health systems approach focusing on building family-centered, coordinated, comprehensive care in community settings. Most of the changes in all the sectors are the result of the advocacy and engagement of parents and families; the Maternal and Child Health Bureau was a supportive and innovative leader for family-professional partnerships. Much work on understanding disparities across the sectors has led to more recent focus on equity.

Introduction: Most pregnancies are low-risk. However, sometimes women develop pre-eclampsia. The incidence varies based on different studies (Havers-Borgersen et al., 2023, 10.1136/jech-2023-220829).Pre-eclampsia is characterized by elevated blood pressure, protein in the urine, and excessive swelling and occurs after 20 weeks of pregnancy though in the case of severe symptoms, all may not be required for diagnosis (Bajpai et al., 2023). Many strategies exist to identify women with pre-eclampsia and to treat it. There are known immediate risks to both the mother and fetus. Some of these risks extend beyond the immediate postpartum period. Much less is known regarding the long-term risks. Therefore, the purpose of our study was to conduct a systematic review of the long-term complications related to pre-eclampsia.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to guide this systematic review. PubMed, CINAHL, Medline, Scopus, PschINFO, and Google Scholar were used to identify relevant articles. We focused on articles published within the last 5 years. Search terms were pre-eclampsia and complications, pregnancy-induced hypertension and complications, long-term complications of pre-eclampsia, and long-term follow-up of pre-eclampsia.

Results: Two hundred and fifty-eight articles were identified; further analysis identified 91 that seemed relevant. After a thorough review, 19 articles were deemed relevant to identify complications women experience following pre-eclampsia.

Discussion: Cardiovascular disease is a major long-term risk. Early-onset pre-eclampsia contributes the greatest risk. Health promotion interventions that target women following a diagnosis of pre-eclampsia are needed. Inadequate knowledge exists to guide efforts to prevent long-term sequelae from pre-eclampsia.

There is evidence of an overall decline in women's mental health, particularly those with young children, in the wake of the COVID-19 pandemic. However, research has also found heterogeneity in women's mental health responses. This longitudinal study sampled low-income women with young children by recruiting from the government's child care financial subsidy waitlist. To examine heterogeneity in women's mental health responses to COVID-19, a latent transition analysis was employed to identify profiles of anxiety, depression, and stress among 289 low-income mothers. Using these identified profiles, we examined the transitional patterns between profiles before and during COVID-19 and the sociodemographic and familial factors related to these profiles. A three-profile solution was identified prior to COVID-19 and a four-profile solution during COVID-19, with some profiles exhibiting qualitatively different defining characteristics. Latent transition analyses found diverse patterns of mental health changes after the onset of COVID-19. Mothers with better mental health prior to COVID-19 tended to have the most stable mental health during COVID-19. In contrast, mothers who were highly stressed prior to COVID-19 were equally likely to improve or decline after the onset of the pandemic. In addition, the relationships between race, parenting practices, child temperament, and child mental health were significantly related to mothers' mental health profiles. These findings describe mothers' experiences and areas where policymakers and practitioners can tailor support to low-income women with young children.

Objectives: The aim of the present study was to investigate the knowledge and attitudes of first-time pregnant women regarding hearing loss in infants, and to identify the key factors that influence their perceptions.

Methods: After validating and ensuring the reliability of a well-structured questionnaire consisting of 15 items, it was distributed to a total of 400 pregnant women who were experiencing their first pregnancies. Utilizing a cluster sampling method, participants were selected from both public hospitals and private gynecologist offices across diverse geographic regions in Tehran, Iran. Participants were asked to respond on a three-point scale (No, Not Sure, Yes). The results were analyzed using both descriptive and analytic statistics.

Results: The translated questionnaire exhibited suitable face validity, test-retest reliability, and internal consistency. Findings revealed the highest maternal knowledge for "newborns can be born with hearing loss "(77.5%) and the lowest knowledge score was observed for "delayed birth cry can lead to hearing loss" (23.8%). Regarding attitudes, 72.5% of mothers scored above the mean of 5.65 out of 6, indicating a preference for early diagnosis and intervention. Several factors, such as education level and the mother's city of residence, showed a significant correlation with certain knowledge and attitude-related questions. Notably, individuals receiving care at public hospitals showed greater knowledge compared to those visiting private clinics.

Conclusions for practice: Mothers play a crucial role in child health and need to have a thorough understanding of pediatric diseases in order to make informed decisions. One particular condition that mothers should be well-informed about is hearing loss, as it has a significant impact on language development. However, this study reveals that there are gaps in maternal knowledge when it comes to the specific causes of hearing loss.

Infant Mental Health Home Visiting (IMH-HV) is a needs-driven, relationship-based home visiting intervention with demonstrated positive outcomes for parents and young children. Prior research found that higher therapeutic alliance (TA) was associated with improved program retention and provider race affected TA and retention for clients. The objective of this quality improvement project was to inform improvements to IMH-HV provider trainings to better prepare providers to effectively engage and support diverse families. Focus groups or individual interviews were completed with 18 providers and 7 clients (parents/caregivers). Participants self-selected into one of three groups offered separately to providers and clients: White identifying, Black identifying and Non-Specified identity groups. A racially diverse, interdisciplinary team facilitated focus groups and interviews and conducted thematic analysis of the data. Analysis identified barriers and opportunities for effective engagement of clients: when providers and clients are of different racial/ethnic backgrounds, provider attempts to forge a connection may make families feel 'othered'; providers may not see their racial identity as salient, yet it influences their practice and the establishment of rapport with families; patience, tolerating discomfort, and allowing a family to determine whether the provider can be trusted are key. Effective IMH-HV practice with clients of diverse backgrounds requires a high level of self-understanding on the part of providers. Enhancing training to promote deeper consideration of both the perspectives of diverse clients and the salience of one's own identity has potential to reduce barriers to TA, improve program retention, and address health disparities.

Objectives: This study aimed to explore the impact of the COVID-19 pandemic and associated stay-at-home orders on the breastfeeding experiences of U.S. people a identify facilitators and barriers to breastfeeding during this period, and to assess the effects of maternal stress and misinformation on breastfeeding practices.

Methods: U.S. women with infants were selected through purposive and convenience sampling. An online survey, distributed during summer 2020, measured changes in infant feeding practices, maternal stress levels, use of lactation support resources, and the influence of misinformation on feeding decisions. Quantitative data were analyzed using descriptive statistics, and qualitative responses underwent thematic analysis.

Results: Our sample (n = 1,861) revealed that 34% of U.S. women realized the pandemic affected their feeding practices, 544 women provided qualitative data. Major themes from qualitative analysis included ease of breastfeeding at home, bonding, increased breastfeeding duration, and challenges like limited access to lactation support. Logistic regressions highlighted demographic influences on breastfeeding practices, with no significant effects found related to the child's age or women's income on changes in feeding practices.

Conclusions for practice: The COVID-19 pandemic substantially impacted breastfeeding experiences of U.S. women, yielding insights for future policy and healthcare practices. The findings underscore the potential benefits of telehealth lactation support services and flexible remote work environments for breastfeeding people. Clear and scientifically-grounded communication regarding breastfeeding, mental health support, and policy development, are essential to promote equitable and flexible work and maternity leave options for breastfeeding people especially during global health crises.