Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.005
Kim Gannon
Stroke continues to be a major public health concern, accounting for more than 800,000 strokes per year and remains the leading cause of disability. Stroke systems of care are comprehensive frameworks designed to ensure efficient and effective management of stroke patients. This article provides a brief overview of the coordinated network of healthcare providers, emergency medical services, and hospitals working together to deliver timely and specialized care including pre-hospital care, acute hospital care, rehabilitation, and community reintegration.
{"title":"Stroke Systems of Care:: A Systematic Approach to Saving Neurons.","authors":"Kim Gannon","doi":"10.32481/djph.2023.08.005","DOIUrl":"https://doi.org/10.32481/djph.2023.08.005","url":null,"abstract":"<p><p>Stroke continues to be a major public health concern, accounting for more than 800,000 strokes per year and remains the leading cause of disability. Stroke systems of care are comprehensive frameworks designed to ensure efficient and effective management of stroke patients. This article provides a brief overview of the coordinated network of healthcare providers, emergency medical services, and hospitals working together to deliver timely and specialized care including pre-hospital care, acute hospital care, rehabilitation, and community reintegration.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"16-19"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/a3/djph-93-005.PMC10494794.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.001
O. Khan, Tim Gibbs
{"title":"In This Issue","authors":"O. Khan, Tim Gibbs","doi":"10.32481/djph.2023.08.001","DOIUrl":"https://doi.org/10.32481/djph.2023.08.001","url":null,"abstract":"","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 1","pages":"3 - 3"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43362719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.011
Nancy Devereux, Ashley M Berns
Strokes are a common medical condition in the United States, including in Delaware. An under-recognized effect of stroke is the impact on mood that often occurs. Many individuals develop depression, anxiety, PTSD, and other psychological sequelae. These disorders can significantly affect their lives and their relationships. The emotional effects of stroke pose a public health problem for our residents, leading to devastating decreases in the quality of life for the patient and the family. These challenges negatively impact the community due to the associated healthcare and economic burdens. The population of the State of Delaware is growing, and the proportion of senior residents, who are also at greater risk for strokes, is also increasing. Strokes will remain an ongoing important clinical concern for our healthcare providers. Emotional changes after a stroke will occur in many Delaware residents who suffer a stroke. The emotional sequelae of stroke are under-treated. It is critical for healthcare professionals to be trained to recognize, assess, and treat the psychological disorders that can result from having a stroke. This article provides an overview of the major psychological effects of stroke, recommended assessment tools, promising treatment trends, and directions for further research. Improving our ability to detect and treat these difficult emotional challenges can facilitate effective treatment and prevention strategies and increase quality of life for stroke survivors, their loved ones, and their communities.
{"title":"Evaluation & Treatment of Psychological Effects of Stroke.","authors":"Nancy Devereux, Ashley M Berns","doi":"10.32481/djph.2023.08.011","DOIUrl":"https://doi.org/10.32481/djph.2023.08.011","url":null,"abstract":"<p><p>Strokes are a common medical condition in the United States, including in Delaware. An under-recognized effect of stroke is the impact on mood that often occurs. Many individuals develop depression, anxiety, PTSD, and other psychological sequelae. These disorders can significantly affect their lives and their relationships. The emotional effects of stroke pose a public health problem for our residents, leading to devastating decreases in the quality of life for the patient and the family. These challenges negatively impact the community due to the associated healthcare and economic burdens. The population of the State of Delaware is growing, and the proportion of senior residents, who are also at greater risk for strokes, is also increasing. Strokes will remain an ongoing important clinical concern for our healthcare providers. Emotional changes after a stroke will occur in many Delaware residents who suffer a stroke. The emotional sequelae of stroke are under-treated. It is critical for healthcare professionals to be trained to recognize, assess, and treat the psychological disorders that can result from having a stroke. This article provides an overview of the major psychological effects of stroke, recommended assessment tools, promising treatment trends, and directions for further research. Improving our ability to detect and treat these difficult emotional challenges can facilitate effective treatment and prevention strategies and increase quality of life for stroke survivors, their loved ones, and their communities.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"62-69"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/21/djph-93-011.PMC10494802.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.010
Christine V Cook, Rebecca Hunting Pompon
Health literacy, or the ability to find, understand, and use information to make well-informed health decisions, has been linked to post-stroke rehabilitation outcomes. Importantly, barriers to health literacy stem from stroke survivor characteristics, clinician practices, institutional norms, as well as systemic variables. These barriers impact recovery and rehabilitation outcomes. To address these obstacles, clinicians can learn from the evidence-based practices used by speech-language pathologists in their work with stroke survivors with aphasia, a language impairment that can follow stroke. These methods to overcome communication barriers are appropriate and recommended for patients and family members regardless of stroke impairment, and include a transdisciplinary care model, multimodal approaches to patient education, along with consistent engagement with patients and their care partners. These strategies may be adopted for both personal and organizational health literacy efforts and help optimize the rehabilitation and recovery outcomes of stroke survivors with and without aphasia.
{"title":"Lessons on Health Literacy and Communication in Post-Stroke Rehabilitation:: A Primer and Proposal.","authors":"Christine V Cook, Rebecca Hunting Pompon","doi":"10.32481/djph.2023.08.010","DOIUrl":"https://doi.org/10.32481/djph.2023.08.010","url":null,"abstract":"<p><p>Health literacy, or the ability to find, understand, and use information to make well-informed health decisions, has been linked to post-stroke rehabilitation outcomes. Importantly, barriers to health literacy stem from stroke survivor characteristics, clinician practices, institutional norms, as well as systemic variables. These barriers impact recovery and rehabilitation outcomes. To address these obstacles, clinicians can learn from the evidence-based practices used by speech-language pathologists in their work with stroke survivors with aphasia, a language impairment that can follow stroke. These methods to overcome communication barriers are appropriate and recommended for patients and family members regardless of stroke impairment, and include a transdisciplinary care model, multimodal approaches to patient education, along with consistent engagement with patients and their care partners. These strategies may be adopted for both personal and organizational health literacy efforts and help optimize the rehabilitation and recovery outcomes of stroke survivors with and without aphasia.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/8e/djph-93-010.PMC10494792.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.004
Waimei Tai
Atrial fibrillation is the culprit causal mechanism of twenty percent of acute ischemic strokes. As the population of Delaware ages, atrial fibrillation is a growing cause of stroke. Thus, the detection of atrial fibrillation and treatment of this cardioembolic risk factor of stroke is paramount.
{"title":"Atrial Fibrillation:: A Common Cause of Stroke.","authors":"Waimei Tai","doi":"10.32481/djph.2023.08.004","DOIUrl":"https://doi.org/10.32481/djph.2023.08.004","url":null,"abstract":"<p><p>Atrial fibrillation is the culprit causal mechanism of twenty percent of acute ischemic strokes. As the population of Delaware ages, atrial fibrillation is a growing cause of stroke. Thus, the detection of atrial fibrillation and treatment of this cardioembolic risk factor of stroke is paramount.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"12-15"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/38/djph-93-004.PMC10494795.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.015
Timothy E Gibbs, Katherine Smith
{"title":"The Nation Needs to Invest in Public Health Now.","authors":"Timothy E Gibbs, Katherine Smith","doi":"10.32481/djph.2023.08.015","DOIUrl":"https://doi.org/10.32481/djph.2023.08.015","url":null,"abstract":"","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"90"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/dc/djph-93-015.PMC10494797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.007
Sudhakar Satti, Thinesh Sivapatham
Mechanical thrombectomy (MT) is a minimally invasive, fluoroscopically guided procedure to remove clots from the arteries in the head and neck. The procedure can be performed very quickly and effectively, with low complication rates, as techniques and technology have advanced in recent years. MT is among the most efficacious procedures performed today, with a very low number needed to treat (NNT) to impact outcomes. Expanded indications for MT include patients with large core infarcts, extended time windows from stroke onset, more distal occlusions, and milder symptoms. Trials have shown a significant benefit of MT in terms of reduced disability in nearly every patient population studied.
{"title":"Update on Neurointerventional Therapy for the Treatment of Acute Cerebral Ischemia.","authors":"Sudhakar Satti, Thinesh Sivapatham","doi":"10.32481/djph.2023.08.007","DOIUrl":"https://doi.org/10.32481/djph.2023.08.007","url":null,"abstract":"<p><p>Mechanical thrombectomy (MT) is a minimally invasive, fluoroscopically guided procedure to remove clots from the arteries in the head and neck. The procedure can be performed very quickly and effectively, with low complication rates, as techniques and technology have advanced in recent years. MT is among the most efficacious procedures performed today, with a very low number needed to treat (NNT) to impact outcomes. Expanded indications for MT include patients with large core infarcts, extended time windows from stroke onset, more distal occlusions, and milder symptoms. Trials have shown a significant benefit of MT in terms of reduced disability in nearly every patient population studied.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"30-32"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/b7/djph-93-007.PMC10494793.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.32481/djph.2023.08.002
Lee P Dresser
{"title":"Interview with Two Delaware Stroke Survivors.","authors":"Lee P Dresser","doi":"10.32481/djph.2023.08.002","DOIUrl":"https://doi.org/10.32481/djph.2023.08.002","url":null,"abstract":"","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 3","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/02/djph-93-002.PMC10494805.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-12eCollection Date: 2023-06-01DOI: 10.32481/djph.2023.06.014
Mary Louise Mitsdarffer, Rebecca McColl, Erin Nescott, Jim Bianchetta, Eric K Layland, Tibor Tóth
Objective: In this article, we examine the issue of LGBTQ+ youth homelessness in Delaware, summarize current services available and prior research work that has been done, examining the number, needs, and experiences of unaccompanied unhoused LGBTQ+ youth.
Methods: We provide a literature review detailing risks associated with LGBTQ+ youth homelessness, resources available, and prior studies and surveys examining this population.
Results: LGBTQ+ youth experiencing homelessness are particularly vulnerable to physical and mental health challenges, abuse, and violence. The unique needs of this population necessitate specialized resources, yet there are a limited number of such resources available in Delaware and a dearth of information on youth homelessness in general, including LGBTQ+ youth. For example, administrative barriers exist for unaccompanied queer youth seeking shelter services, such as need for legal identification or being grouped in shelter populations based on sex assigned at birth rather than gender identity. Exposure to unsafe environments is a general problem for queer youth. This can make public spaces feel unsafe and increase risk of physical or mental harm, mistreatment, or abuse when seeking shelter outside of agency services and resources. In order to accurately identify and appropriately serve this population, additional research is necessary.
Conclusions: Evidence building is a critical first step in creating an effective study to examine the issue of LGBTQ+ youth homelessness in Delaware. With the evidence acquired in our literature review our next step to establish an informed methodology is to hold service provider and LGBTQ+ lived experience focus groups. Through a qualitative approach we aim to learn how to appropriately utilize the quantitative tools identified in our analysis and to assess what questions are missing to advance the needs of this population.
{"title":"LGBTQ+ Youth Homelessness in Delaware:: Building a Case for Targeted Surveillance and Assessment of LGBTQ+ Youth Needs and Experiences.","authors":"Mary Louise Mitsdarffer, Rebecca McColl, Erin Nescott, Jim Bianchetta, Eric K Layland, Tibor Tóth","doi":"10.32481/djph.2023.06.014","DOIUrl":"10.32481/djph.2023.06.014","url":null,"abstract":"<p><strong>Objective: </strong>In this article, we examine the issue of LGBTQ+ youth homelessness in Delaware, summarize current services available and prior research work that has been done, examining the number, needs, and experiences of unaccompanied unhoused LGBTQ+ youth.</p><p><strong>Methods: </strong>We provide a literature review detailing risks associated with LGBTQ+ youth homelessness, resources available, and prior studies and surveys examining this population.</p><p><strong>Results: </strong>LGBTQ+ youth experiencing homelessness are particularly vulnerable to physical and mental health challenges, abuse, and violence. The unique needs of this population necessitate specialized resources, yet there are a limited number of such resources available in Delaware and a dearth of information on youth homelessness in general, including LGBTQ+ youth. For example, administrative barriers exist for unaccompanied queer youth seeking shelter services, such as need for legal identification or being grouped in shelter populations based on sex assigned at birth rather than gender identity. Exposure to unsafe environments is a general problem for queer youth. This can make public spaces feel unsafe and increase risk of physical or mental harm, mistreatment, or abuse when seeking shelter outside of agency services and resources. In order to accurately identify and appropriately serve this population, additional research is necessary.</p><p><strong>Conclusions: </strong>Evidence building is a critical first step in creating an effective study to examine the issue of LGBTQ+ youth homelessness in Delaware. With the evidence acquired in our literature review our next step to establish an informed methodology is to hold service provider and LGBTQ+ lived experience focus groups. Through a qualitative approach we aim to learn how to appropriately utilize the quantitative tools identified in our analysis and to assess what questions are missing to advance the needs of this population.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 2","pages":"80-86"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/b7/djph-92-014.PMC10445598.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-12eCollection Date: 2023-06-01DOI: 10.32481/djph.2023.06.025
Khaleel Hussaini, George Yocher
Objective: Assess differences in postpartum contraceptive use and pregnancy intentions in women with a recent live birth who delivered a neonatal abstinence syndrome (NAS) affected infant.
Study design: Using linked Delaware Birth Certificate Data, Hospital Discharge Data and PRAMS data for 2012-2018 (n = 6,358 singleton births), we assessed differences among women with and without a delivery of an NAS-affected infant by effective postpartum contraceptive use and pregnancy intentions. We calculated prevalence estimates, crude (cPOR), and prevalence odds ratios adjusted (aPOR) for NAS by maternal characteristics. We used alpha ≤ 0.05 to determine statistical significance.
Results: Prevalence of NAS was 2.2% (95% CI: 1.8 - 2.6). Effective postpartum contraceptive use was 60.4% (95% CI: 51.9-69.0) among women with delivery of an NAS-affected infant compared with a non-NAS delivery 56.4% (95% CI: 55.1-57.8%) and cPOR was 1.2 (95% CI: 0.8-1.7). Prevalence of intended pregnancy was 26.5% (95% CI: 18.9-34.0) among women with delivery of an NAS-affected infant compared with a non-NAS delivery 53.0% (95% CI: 51.7-54.4) and cPOR was 0.3 (95% CI: 0.2-0.5). After adjustment, women who delivered an NAS-affected infant had lower odds (aPOR = 0.5; 95% CI: 0.3-0.8) of indicating that their pregnancy was intended as compared to those who did not deliver an NAS-affected infant.
Conclusions: Our study found no association between delivery of an NAS-affected infant and use of an effective postpartum contraceptive method. However, we found that pregnancy intendedness was lower among women delivering an NAS-affected infant compared with women without an NAS delivery even after accounting for maternal characteristics.
目标:评估最近分娩过新生儿禁欲综合症(NAS)婴儿的活产妇女产后避孕药具使用情况和怀孕意愿的差异:评估最近分娩过新生儿禁欲综合征(NAS)患儿的活产妇女在产后避孕药具使用和怀孕意愿方面的差异:利用 2012-2018 年特拉华州出生证明数据、医院出院数据和 PRAMS 数据(n = 6358 例单胎新生儿),我们评估了分娩过受 NAS 影响婴儿的女性与未分娩过受 NAS 影响婴儿的女性在有效产后避孕药具使用和怀孕意愿方面的差异。我们按产妇特征计算了NAS的流行率估计值、粗略值(cPOR)和调整后的流行率几率比(aPOR)。我们使用α≤0.05来确定统计显著性:NAS发生率为2.2%(95% CI:1.8 - 2.6)。分娩受 NAS 影响婴儿的妇女产后有效避孕率为 60.4%(95% CI:51.9-69.0),而未分娩受 NAS 影响婴儿的妇女产后有效避孕率为 56.4%(95% CI:55.1-57.8%),cPOR 为 1.2(95% CI:0.8-1.7)。分娩过受 NAS 影响婴儿的妇女中,计划怀孕率为 26.5%(95% CI:18.9-34.0),而未分娩过受 NAS 影响婴儿的妇女中,计划怀孕率为 53.0%(95% CI:51.7-54.4),cPOR 为 0.3(95% CI:0.2-0.5)。经调整后,与未分娩受 NAS 影响婴儿的妇女相比,分娩受 NAS 影响婴儿的妇女表示其怀孕是有意的几率较低(aPOR = 0.5;95% CI:0.3-0.8):我们的研究发现,分娩受 NAS 影响的婴儿与使用有效的产后避孕方法之间没有关联。然而,我们发现,与未分娩受 NAS 影响婴儿的妇女相比,分娩受 NAS 影响婴儿的妇女的妊娠意愿较低,即使考虑了母亲的特征也是如此。
{"title":"Postpartum Contraceptive Use, Pregnancy Intentions in Women With and Without a Delivery of a NAS-Affected Infant in Delaware, 2012-2018.","authors":"Khaleel Hussaini, George Yocher","doi":"10.32481/djph.2023.06.025","DOIUrl":"10.32481/djph.2023.06.025","url":null,"abstract":"<p><strong>Objective: </strong>Assess differences in postpartum contraceptive use and pregnancy intentions in women with a recent live birth who delivered a neonatal abstinence syndrome (NAS) affected infant.</p><p><strong>Study design: </strong>Using linked Delaware Birth Certificate Data, Hospital Discharge Data and PRAMS data for 2012-2018 (n = 6,358 singleton births), we assessed differences among women with and without a delivery of an NAS-affected infant by effective postpartum contraceptive use and pregnancy intentions. We calculated prevalence estimates, crude (cPOR), and prevalence odds ratios adjusted (aPOR) for NAS by maternal characteristics. We used alpha ≤ 0.05 to determine statistical significance.</p><p><strong>Results: </strong>Prevalence of NAS was 2.2% (95% CI: 1.8 - 2.6). Effective postpartum contraceptive use was 60.4% (95% CI: 51.9-69.0) among women with delivery of an NAS-affected infant compared with a non-NAS delivery 56.4% (95% CI: 55.1-57.8%) and cPOR was 1.2 (95% CI: 0.8-1.7). Prevalence of intended pregnancy was 26.5% (95% CI: 18.9-34.0) among women with delivery of an NAS-affected infant compared with a non-NAS delivery 53.0% (95% CI: 51.7-54.4) and cPOR was 0.3 (95% CI: 0.2-0.5). After adjustment, women who delivered an NAS-affected infant had lower odds (aPOR = 0.5; 95% CI: 0.3-0.8) of indicating that their pregnancy was intended as compared to those who did not deliver an NAS-affected infant.</p><p><strong>Conclusions: </strong>Our study found no association between delivery of an NAS-affected infant and use of an effective postpartum contraceptive method. However, we found that pregnancy intendedness was lower among women delivering an NAS-affected infant compared with women without an NAS delivery even after accounting for maternal characteristics.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"9 2","pages":"134-140"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/21/djph-92-025.PMC10445619.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}