Maternal and Child Health Journal最新文献

{"title":"Strategies for Promoting Doula Inclusivity in the Labor and Delivery Setting.","authors":"Holly DeBernard Perkins, Christine Isaacs","doi":"10.1007/s10995-025-04051-4","DOIUrl":"https://doi.org/10.1007/s10995-025-04051-4","url":null,"abstract":"<p><strong>Purpose: </strong>Our facility aimed to establish a standardized process to guide healthcare team members to incorporate doulas in the labor and delivery setting while meeting regulatory and safety requirements and promoting operational transparency.</p><p><strong>Description: </strong>Doulas provide emotional, physical, and educational support to patients and families throughout the pregnancy, birth, and postpartum journey. Doula care has been identified with improved maternal and neonatal birth outcomes, as well as improved perceptions of the birthing process.</p><p><strong>Assessment: </strong>Our facility lacked a standard operating procedure for successfully incorporating doulas into the healthcare team.</p><p><strong>Conclusion: </strong>We developed strategies to promote doula inclusivity in our labor and delivery environment with safety and quality at the core of our focus.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: What Do Mothers Know About Nutrition? Impacts on Childhood Nutrition Outcomes in Sub-Saharan Africa.","authors":"Achamyeleh Birhanu Teshale, Godness Kye Biney, Michael Sarfo, Edward Kwabena Ameyaw, Sanni Yaya","doi":"10.1007/s10995-025-04071-0","DOIUrl":"10.1007/s10995-025-04071-0","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Longer Maternal Leukocyte Telomere Length in the Immediate Postpartum Period and Preterm Birth in a Predominately Latina Cohort of Mothers.","authors":"Usah Dutson, Jue Lin, Laura L Jelliffe-Pawlowski, Kimberly Coleman-Phox, Larry Rand, Janet M Wojcicki","doi":"10.1007/s10995-025-04056-z","DOIUrl":"https://doi.org/10.1007/s10995-025-04056-z","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the association between maternal leukocyte telomere length (LTL) in the immediate postpartum period and moderate to late preterm birth (32- < 37 weeks) among Latinas, a population at high risk for preterm birth.</p><p><strong>Methods: </strong>Maternal LTL was measured using quantitative polymerase chain reaction at delivery in a prospective San Francisco primarily Latina birth cohort. Logistic regression models were used to investigate the association between postpartum maternal LTL and preterm birth. Maternal LTL was analyzed as a continuous predictor.</p><p><strong>Results: </strong>Out of 194 participants, 23 (11.9%) had preterm delivery. Longer postnatal maternal LTL was associated with preterm birth (crude OR 4.68; 95% confidence interval (CI) 1.07, 20.6, p = 0.039; adjusted OR 12.8, 95% CI 1.83, 99.9, p = 0.010). Age-stratified analysis showed that being under 35 years increased the effect size of the association between maternal LTL and preterm birth (adjusted OR 32.5, 95% CI 2.58, 597, p < 0.01).</p><p><strong>Conclusions for practice: </strong>Latina mothers with moderate to late preterm infants had longer LTL in the immediate postpartum period compared to those with term infants. This association was stronger for mothers under the age of 35 years. LTL may serve as a biomarker to better understand the pathophysiology and risk of preterm birth and could inform targeted interventions for prevention and early detection. Future studies are needed to understand physiological changes in maternal LTL from the prenatal to postnatal period in relation to birth outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-Level Spending on Children Associated with Unequal Benefits to School Readiness.","authors":"Taryn W Morrissey, Katherine Engel, Margot I Jackson","doi":"10.1007/s10995-025-04068-9","DOIUrl":"https://doi.org/10.1007/s10995-025-04068-9","url":null,"abstract":"<p><strong>Objectives: </strong>To examine associations between state-level public investments in programming for children and parents' reports of their children's kindergarten readiness.</p><p><strong>Methods: </strong>We use regression approaches with publicly available, nationally representative data to examine how time and state variation in public spending on children relates to parents' concerns about children's development. We link data on annual state-level spending on health and early learning from the Urban Institute's State-by-State Spending on Kids Dataset and the National Institute for Early Education Research to child-level data from the 2003/2004, 2007/2008, and 2011/2012 waves of the National Survey of Children's Health (NCHS), focusing on a subsample of parents with one or more children under age six (N = 56,736).</p><p><strong>Results: </strong>Child-related public spending on both health and early education is associated with decreases in parents' concerns about their children's physical health and motor development. A 15% increase in average health spending and early education spending per child per year is associated with a reduction in parents' concerns about children's health and motor development of about 3% and 2% of a standard deviation (SD), respectively. Associations between spending and concerns about early learning and social-emotional development are negative but not significant. Among socioeconomically disadvantaged or racial and ethnic minority parents, spending is associated with smaller reductions in concerns.</p><p><strong>Conclusions for practice: </strong>Public spending on children is associated with fewer parents' concerns about their children's development, but less so among disadvantaged families. It is possible that public spending levels are not adequate to narrow disparities in early opportunity and outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Systems of Care on Emotional Well-Being of Primary Family Caregivers of Children with Medical Complexity.","authors":"Jessica L Schnell, Julia B Tager, Ansley E Kenney, Paulina S Lim, Samantha A Everhart, Sarah Johaningsmeir, Kathryn A Balistreri, Amy Morgan-Tautges, Kevin E Berridge, Maura Brophey, Charles B Rothschild, Matthew C Scanlon, W Hobart Davies, K Jane Lee","doi":"10.1007/s10995-025-04066-x","DOIUrl":"https://doi.org/10.1007/s10995-025-04066-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the experiences of caregivers of children with medical complexity (CMC) enrolled in a complex care program, focusing on their interactions with the healthcare system and the impact on caregiver well-being.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with 20 caregivers, and data were analyzed using interpretative phenomenological analysis. The interviews covered topics such as navigating the medical system, accessing resources, and interactions with healthcare providers.</p><p><strong>Results: </strong>Caregivers faced challenges in navigating the healthcare system, including scheduling appointments, finding suitable treatment plans, and managing hospitalizations. They expressed the need for more practical, financial, and informational resources to support their caregiving responsibilities. Access to respite care was identified as a significant challenge, with limited availability and affordability. Caregivers highlighted the importance of connecting with other caregivers and accessing accurate information specific to their child's condition.</p><p><strong>Conclusions for practice: </strong>The findings emphasize the unmet needs of caregivers of CMC and the barriers they face within the healthcare system. To support caregiver well-being, interventions should address these barriers by improving infrastructural support, enhancing training for in-home caregivers, and advocating for comprehensive support services for the entire family. Involving caregivers in the development and implementation of interventions is crucial to ensure their feasibility, applicability, and desirability. By addressing these challenges and tailoring interventions to the unique needs of caregivers of CMC, healthcare providers can promote better outcomes for both caregivers and their CMC.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Potential Mediating Role of Maternal Mental Health in the Association Between Socioeconomic Deprivation and Child Development Outcomes.","authors":"Kenneth Okelo, Aja Murray, Josiah King, Iain Hardie, Hildigunnur Anna Hall, Emily Luedecke, Louise Marryat, Lucy Thompson, Helen Minnis, Michael Lombardo, Philip Wilson, Bonnie Auyeung","doi":"10.1007/s10995-025-04050-5","DOIUrl":"https://doi.org/10.1007/s10995-025-04050-5","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic deprivation has been linked to negative child developmental outcomes including brain development, psychological well-being, educational attainment, and social-emotional well-being. Maternal mental health has also been linked to mothers' parenting practices and their children's developmental outcomes. However, limited evidence exists regarding the role of maternal mental health (prenatal and postnatal) in the association between socioeconomic deprivation and children's developmental outcomes.</p><p><strong>Methods: </strong>We examined the potential role of maternal mental health in the association between socioeconomic deprivation (SED) and child development outcomes. We used a large linked administrative health dataset covering children born between 2011 and 2015 in Greater Glasgow and Clyde, Scotland. Of the 76,483 participants, 55,856 mothers with matched children's developmental outcome data were included. A mediation analysis model, adjusted for confounders and covariates, was used.</p><p><strong>Results: </strong>Maternal mental health assessed by a history of hospital admissions mediated, but to a small extent, the relationship between SED and children's developmental outcomes. The average direct effect (ADE), of SED in the first model with a history of hospital admissions, was ADE: ES = - 0.0875 (95% CI = - 0.097, - 0.08; p < 0.001) and ACME: ES = - 0.0002 (95% CI = - 0.001, - 0.0001; p = 0.01). The proportion mediated by the history of mental health admission was 0.3%.</p><p><strong>Conclusion: </strong>The association between SED and children's developmental outcomes appears to be partially mediated by maternal mental health, although the proportional-mediated effect was very small.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experiences of a Postpartum Cardiovascular Disease Intervention Clinic for Pregnancy Complications.","authors":"Tegan Manthorpe, Margaret Arstall, Prabha H Andraweera, Emily Aldridge","doi":"10.1007/s10995-025-04047-0","DOIUrl":"https://doi.org/10.1007/s10995-025-04047-0","url":null,"abstract":"<p><strong>Objectives: </strong>Experiencing a maternal complication of pregnancy conveys a significantly higher risk of developing premature cardiovascular disease compared to having an uncomplicated pregnancy. Postpartum interventions that aim to improve lifestyle and modifiable risk factors for people in this cohort may reduce cardiovascular disease risk. This study will explore the experiences and barriers to attendance of patients referred to one such clinic located in South Australia.</p><p><strong>Methods: </strong>This qualitative study conducted six focus groups comprised of two-six patients who had attended at least one postpartum intervention clinic appointment (N = 19). Audio recordings were captured and transcribed and NVivo was used to perform a thematic analysis.</p><p><strong>Results: </strong>Participants found the clinic informative as it educated them on their greater risk of cardiovascular disease and how to reduce this risk. They reported wanting more frequent appointments and the ability to opt in for additional contact, including newsletters and social media groups. We also identified several barriers to attendance, including an unclear clinic referral and appointment booking process, and missing clinic correspondence including appointment letters and pathology forms.</p><p><strong>Conclusions for practice: </strong>This study provides insight into the experiences of patients who attended a postpartum cardiovascular disease prevention clinic. The clinic model can be operated in different health care settings to become part of standardized care in the postpartum period for patients who have had a pregnancy complication. Refinement of the clinic model referral and booking processes could reduce potential barriers to patient attendance.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Stress and Early Postpartum Depressive Symptoms in Women with Recent GDM: Implications for Postpartum Lifestyle Programs.","authors":"Jennifer M Dias, Estelle C Kelty, Jacinda M Nicklas, John T Doucette, Sue E Levkoff, Ellen W Seely","doi":"10.1007/s10995-025-04045-2","DOIUrl":"https://doi.org/10.1007/s10995-025-04045-2","url":null,"abstract":"<p><strong>Objectives: </strong>To inform the development and adaptation of lifestyle programs to prevent type 2 diabetes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes (GDM).</p><p><strong>Methods: </strong>Participants are from the Balance after Baby Intervention (BABI) study, a two-year randomized clinical trial of a lifestyle program for women with recent GDM conducted in Boston, MA, and Denver, CO between 2016 and 2019. The Edinburgh Postpartum Depression Scale (EPDS) and Perceived Stress Scale (PSS-10) were administered at an average of 8-weeks postpartum. We defined an EPDS score of ≥ 9 as depressive symptoms and reviewed medical records for medical history. We conducted bivariate analyses to identify predictors of postpartum depressive symptoms, then modeled the odds of postpartum depressive symptoms using multivariable logistic regression and selected the best fit model.</p><p><strong>Results: </strong>Our analysis included 181 women. Thirty-five (19%) scored ≥ 9 on the EPDS. While both perceived stress and whether this was the first pregnancy complicated by GDM were significant in the bivariate analysis, only perceived stress remained a significant predictor of postpartum depressive symptoms in the multivariate regression model (OR 4.34, 95% CI [2.58-7.31]). The effect of first GDM pregnancy was no longer significant in the multivariate model (OR 2.00, 95% CI [0.63-6.33]). Additionally, a mediation model determined that perceived stress fully mediated the effect of first GDM pregnancy on depressive symptoms (Effect ratio, 0.5507/1.5377 = 0.358, p = 0.036).</p><p><strong>Conclusions for practice: </strong>Perceived stress was predictive of postpartum depressive symptoms in women with recent GDM and was found to mediate the relationship between first pregnancy complicated by GDM and postpartum depressive symptoms. Addressing perceived stress in the early postpartum period may be an important target for future lifestyle programs to maximize diabetes prevention efforts.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Childbirth Experience Survey (CBEX): An Analysis of Qualitative Survey data.","authors":"Samia Saeb, Lisa M Korst, Ferina Farahnik, Jeanette McCulloch, Naomi Greene, Moshe Fridman, Kimberly D Gregory","doi":"10.1007/s10995-025-04043-4","DOIUrl":"https://doi.org/10.1007/s10995-025-04043-4","url":null,"abstract":"<p><strong>Background: </strong>In collaboration with community research partners, a national cross-sectional online Childbirth Experience Survey (CBEX) of pregnant and postpartum birthing people was administered in 2016. The linked antepartum-postpartum survey included items across 18 domains (e.g., labor management, pain management, newborn care and feeding), and identified 23 childbirth-specific postpartum patient-reported outcomes (PROs) that were associated with hospital satisfaction. CBEX was implemented in 16 California hospitals to identify hospital-specific opportunities for improvement in care. We analyzed postpartum qualitative survey responses (1) to evaluate the content validity to test the representativeness of existing CBEX domains, (2) to assess for any potential new domains or topics of interest within existing domains, and (3) to use these data to provide hospitals with actionable information for practice improvement.</p><p><strong>Methods: </strong>This was an analysis of qualitative survey data based on the following CBEX item: \"Is there anything else you would like to share about your birth experience?\" Patients could provide multiple comments. Using Atlas.ti Version 8, we mapped participant responses to the 18 existing CBEX domains.</p><p><strong>Results: </strong>Of 525 surveys completed between Oct 2018 and Sept 2020, 172 patients responded to the qualitative item. A total of 235 comments were analyzed and all were able to be mapped to the 18 domains. Qualitative responses highlighted subtleties within several CBEX domains: (1) labor management: pressure from the care team to have a labor induction; (2) pain management: epidural effectiveness, timing, dosage, and education; (3) empathy and respect: issues related to students and residents; and (4) newborn feeding: rough physical handling of patients by nurses, specifically during lactation consults.</p><p><strong>Discussion: </strong>CBEX survey data is currently being utilized in hospitals to inform childbirth-specific quality improvement initiatives. By capturing detailed voluntary participant responses, CBEX provides the opportunity to document and explore nuanced aspects of the childbirth experience and subtleties that may be contributing to maternal dissatisfaction.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do Antenatal Women Want From Their Antenatal Education? A National Survey.","authors":"Eva Larkai, Anna Davies, Miriam Toolan, Mary Lynch, Rachel Plachcinski, Michael Larkin, Abigail Fraser, Christy Burden, Abi Merriel","doi":"10.1007/s10995-025-04048-z","DOIUrl":"https://doi.org/10.1007/s10995-025-04048-z","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal education (ANE) equips pregnant women with knowledge and skills for pregnancy, birth, and the postnatal period. It should facilitate preparation for the whole spectrum of the maternal journey and empower women to make informed decisions. This study aimed to explore the antenatal education needs and preferences of women who are currently pregnant or planning a pregnancy.</p><p><strong>Methods: </strong>A UK wide cross-sectional survey was conducted (September 2019 to July 2020), recruiting women living in the UK, above 16, who were currently pregnant or planning a pregnancy. The survey gathered demographic information, details of current or planned class attendance, preferred ANE providers and desired skills and information. Quantitative data were analysed descriptively, and free-text responses underwent thematic analysis.</p><p><strong>Results: </strong>Of 553 participants included in the analyses, 77% preferred free National Health Service (NHS) classes and 60% planned to attend multiple class types, including paid options. Participants valued practical skills, particularly for labour and the postpartum period, and actively sought perinatal social networks. Multiparous women were less likely to attend classes, citing prior experience or practical barriers. Despite high interest in NHS classes, regional variations in availability and limited accessibility were noted.</p><p><strong>Conclusion: </strong>NHS antenatal classes are a trusted source of ANE, forming a core element of many women's antenatal journey. However, inconsistent provision highlights the need for a standardised, comprehensive curriculum. Flexible delivery models and tailored content are crucial to address diverse needs, particularly for multiparous women and underrepresented groups. Enhanced accessibility could reduce inequalities in ANE provision and improve maternal outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}