Maternal and Child Health Journal最新文献

{"title":"Amplifying Youth Voices in Public Health: Assessing the Sustained Impact of PATCH Youth Engagement Programs on Adolescent Health, Well-Being and Leadership Development.","authors":"Tess I Jewell, Chelsea J Aeschbach","doi":"10.1007/s10995-026-04293-w","DOIUrl":"https://doi.org/10.1007/s10995-026-04293-w","url":null,"abstract":"<p><strong>Introduction: </strong>For over 10 years, the Wisconsin-based Providers and Teens Communicating for Health (PATCH) Program has worked alongside youth ages 14-19 to enhance adolescent health programs, policies, and practices. This evaluation explores the lasting effects on those who participated in the PATCH program as an adolescent.</p><p><strong>Methods: </strong>All former Wisconsin PATCH participants were invited to complete a retrospective pre-post survey that asked them to reflect on their attitudes, actions, and knowledge before and after participating in PATCH. The survey used 5-point Likert scales and open-ended questions to comprehensively assess themes such as job exploration and readiness, relationships and connectedness, advocacy, self-worth, stigma, and health- and healthcare-related knowledge, confidence, and behaviors.</p><p><strong>Results: </strong>A total of 104 past participants completed the survey. All 11 scales showed significant changes (p < .001), and qualitative analysis yielded 6 key themes, including the program's impact on sense of community and interpersonal relationships, advocacy, and workforce development.</p><p><strong>Conclusions: </strong>These findings contribute to the understanding of the long-term benefits of youth engagement in health programs and provide valuable insights for practitioners aiming to develop and enhance similar initiatives. Furthermore, they underscore the critical role of sustained, structured youth involvement in achieving meaningful and lasting improvements in adolescent health.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889147","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":"Association of Mandatory COVID-19 Lockdown Exposure with Increased Maternal Prenatal Smoking and Reduced Fetal Head Growth: A Retrospective Cohort Study.","authors":"Luciana Simes, Sofía Salguero, Rosario Alonso, Eduardo Cuestas","doi":"10.1007/s10995-026-04322-8","DOIUrl":"https://doi.org/10.1007/s10995-026-04322-8","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal psychological distress during COVID-19 has been linked to reduced neonatal brain volume. This study aimed to determine whether mandatory COVID-19 lockdown exposure was associated with reduced fetal head growth and to identify maternal, behavioral, and obstetric factors associated with this relationship.</p><p><strong>Methods: </strong>A retrospective cohort study compared pregnancies during mandatory COVID-19 lockdown (March-December 2020) with the corresponding 2019 period. Women with SARS-CoV-2 infection, multiple gestations, and congenital anomalies or infections were excluded. The primary outcome was third-trimester fetal head circumference (HC) z-score. Covariates included maternal demographic, obstetric, and clinical factors, including prenatal smoking (consistent reporting at every prenatal visit). Linear mixed-effects models with interaction terms were used.</p><p><strong>Results: </strong>A total of 1,116 pregnancies (545 exposed, 571 unexposed) were included. Lockdown exposure was associated with greater weight gain (11 vs. 10 kg, p < 0.01), higher prenatal smoking (6.1% vs. 1.2%, p < 0.01), more hypertensive disorders (7.2% vs. 4.4%, p = 0.04), and longer gestation (39.1 vs. 39.0 weeks, p < 0.01), plus lower third-trimester fetal HC z-scores (0.7 vs. 0.9, p < 0.01). The interaction between lockdown exposure and prenatal smoking was independently associated with reduced fetal HC (β = -1.6; 95% CI, -2.7 to -0.4; P = 0.03); smoking alone was not significant (β = -5.2; P = 0.24).</p><p><strong>Conclusions for practice: </strong>Mandatory COVID-19 lockdown exposure was associated with reduced fetal head growth, in interaction with increased prenatal smoking, highlighting the need for targeted smoking-cessation support during public health emergencies.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888181","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":"Completion of the National Childhood Immunization Schedule and Associated Factors Among Children Aged 24-35 Months in Afghanistan: A Nationwide Analysis of MICS 2022-23.","authors":"Omid Dadras, Muhammad Haroon Stanikzai, Essa Tawfiq, Massoma Jafari","doi":"10.1007/s10995-026-04318-4","DOIUrl":"https://doi.org/10.1007/s10995-026-04318-4","url":null,"abstract":"<p><strong>Background: </strong>Childhood immunization coverage remains low in Afghanistan, but evidence is limited regarding completion of the broader national immunization schedule beyond the first year of life. This study estimated full-schedule immunization coverage and examined factors associated with its completion among Afghan children aged 24-35 months.</p><p><strong>Methods: </strong>We analysed nationally representative data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2022-23, including 6342 children aged 24-35 months. Full immunization was defined according to the MICS TC.11b indicator for completion of all vaccinations included in the national childhood immunization schedule. Survey-weighted analyses estimated vaccine-specific coverage, within-series dropout and provincial variation. A prespecified survey-weighted multivariable logistic regression model was used to identify factors associated with full-schedule completion.</p><p><strong>Results: </strong>Only 16.2% (95% CI 14.7-17.7) of children had completed the full national immunization schedule. Coverage was particularly low for Inactivated Poliovirus Vaccine (IPV2) (24.6%) and measles-containing vaccine (MCV)- 2 (36.8%), and 49.2% of children who had received IPV1 had not received IPV2. Full-schedule completion varied markedly across provinces, from 3.1 to 37.7%. In the adjusted analysis, maternal primary education (AOR 1.55, 95% CI 1.11-2.19) and secondary or higher education (AOR 1.72, 95% CI 1.15-2.57), paternal primary education (AOR 1.68, 95% CI 1.13-2.50) and secondary or higher education (AOR 1.94, 95% CI 1.48-2.55), and maternal mobile-phone ownership (AOR 1.29, 95% CI 1.03-1.61) were associated with greater odds of full-schedule completion.</p><p><strong>Conclusion: </strong>Completion of the national childhood immunization schedule remains very low in Afghanistan, with substantial attrition across multi-dose vaccine series and marked geographical variation. Strengthening continuity of vaccination, follow-up for later doses, and accessible family-focused vaccination communication may help improve schedule completion.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882286","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":"Growing CAPITOL 4 Life: A Case Study of Co-designed Material for the First 1000 Days Using a Modified Double Diamond Approach.","authors":"Andrew P Hills, Sisitha Jayasinghe, Kylie Mulcahy, Kylie Burgess, Lisa Dalton, Kiran D K Ahuja, Roger Hughes, Nuala M Byrne","doi":"10.1007/s10995-026-04320-w","DOIUrl":"https://doi.org/10.1007/s10995-026-04320-w","url":null,"abstract":"<p><strong>Introduction: </strong>Growing CAPITOL 4 Life is a place-based public health initiative focused on the first 1000 days (F1D), from conception to a child's second birthday. It sought to strengthen community capacity for early-childhood health by leveraging local knowledge, assets and partnerships, while moving beyond one-way information provision towards sustained learning, empowerment and collective action. This study retrospectively examined the co-design process through the lens of the Double Diamond.</p><p><strong>Methods: </strong>Parents, educators, service providers and community stakeholders across Burnie, Circular Head and Devonport, Tasmania, participated in co-design workshops. Engagement spanned government, local government, Aboriginal organizations, libraries and community services. The process was facilitated by a place-based systems-change organization and supported by the University of Tasmania. Community members contributed lived experience alongside professional and academic knowledge, with decision-making remaining largely community-led and guided by the principle of \"for the community, by the community.\"</p><p><strong>Results: </strong>Across the four phases, communities moved from sharing experiences and identifying strengths and challenges (Discover), to refining priorities (Define), developing locally relevant resources and learning approaches (Develop), and shaping feasible delivery models (Deliver). The process centered on the F1D domains of Connection, Nutrition, Caring and Moving and resulted in community-informed Evidence Briefs, workshops and playgroup-based learning. Importantly, the Double Diamond was reflected not as a prescribed sequence, but as a recurring pattern of opening outward to explore and narrowing inward to make sense, prioritize and act. Discussions moved organically between what was working, what was missing, what an ideal future might look like and how communities could move towards it.</p><p><strong>Discussion: </strong>The findings suggest that the value of the Double Diamond in public health lies less in adherence to predefined stages than in providing sufficient structure for purposeful exploration while preserving community agency. This flexible approach may support locally relevant, acceptable and trusted solutions, particularly in complex regional settings where effective public health responses must emerge from, rather than be imposed upon, communities.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867376","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":"Women's Quality-of-Life Trajectories During Pregnancy and Postpartum Periods by Mode of Birth: A Prospective Cohort Study.","authors":"Alayna Carrandi, Yanan Hu, Maria Forslund, Jenny Gamble, Debra Creedy, Emily Callander, Valerie Slavin","doi":"10.1007/s10995-026-04298-5","DOIUrl":"https://doi.org/10.1007/s10995-026-04298-5","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the quality-of-life scores of women during pregnancy and postpartum and compare the differences by mode of birth.</p><p><strong>Methods: </strong>A secondary analysis of a prospective, observational cohort study comprising 2866 pregnant women in Queensland, Australia. Women's quality-of-life scores were collected at 36 weeks of gestation and 6- and 12-week postpartum and converted into utility values.</p><p><strong>Results: </strong>On average, quality-of-life utility scores increased from 36 weeks of gestation to 12 weeks postpartum, regardless of birth type. After adjusting for socioeconomic characteristics, women who went on to have a planned caesarean section had a significantly lower utility score at 36 weeks of gestation compared to women who went on to have a spontaneous vaginal birth (adjusted mean difference =  - 0.07; 95% CI - 0.11, - 0.02); women who did not have select birth type had a statistically significantly lower utility score at 36 weeks of gestation compared to women who had a select birth type (adjusted mean difference =  - 0.05; 95% CI - 0.08, - 0.02). No significant differences were observed for other birth types at 6- and 12-week postpartum.</p><p><strong>Conclusions for practice: </strong>Women's quality of life improves from late pregnancy to postpartum. Further research is needed to develop targeted interventions to improve quality of life among women at higher risk of low quality of life and adverse pregnancy and birth outcomes, however we did not identify any differences by mode of birth.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819927","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":"Association between High-Risk Pregnancy History and High-Efficacy Postpartum Contraception Use in North Carolina.","authors":"Maya E Cox-Terry, Elizabeth D Enright, Godwin Y Dogbey, James M Edwards","doi":"10.1007/s10995-026-04297-6","DOIUrl":"https://doi.org/10.1007/s10995-026-04297-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate factors associated with postpartum use of high-efficacy contraception among postpartum individuals in North Carolina and to assess whether a history of high-risk pregnancy was associated with increased use of WHO Tier 1 contraceptive methods.</p><p><strong>Study design: </strong>North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2020 were analyzed. The analytic sample included 6,993 postpartum respondents. A composite high-risk pregnancy history index was created using self-reported and birth certificate variables including preterm birth, low birth weight, obesity, hypertension, diabetes, depression, and inadequate prenatal care. Multivariable logistic regression was used to evaluate factors associated with postpartum use of WHO Tier 1 contraception.</p><p><strong>Results: </strong>A cumulative sample of 13,866 postpartum persons were selected and invited to complete the survey; 6,993 responded and were considered participants. History of high-risk pregnancy was associated with slightly increased odds of postpartum Tier 1 contraception use (aOR 1.18, 95% CI 1.00-1.39, p < 0.05), although the association was modest. Other significant factors associated with high-efficacy contraception use included multiparity (aOR = 2.00, 95% CI 1.70 to 2.36), planned conception (aOR = 0.72, 95% CI 0.62 to 0.85), living infant (aOR = 2.85, 95%CI 1.42 to 5.72), postpartum contraception counseling (aOR = 0.36, 95% CI 0.28 to 0.45), postpartum depression screening (aOR = 1.40, 95% CI 1.05 to 1.89), Black and Asian races (aOR = 0.78, 95% CI 0.64 to 0.95 and aOR = 0.36, 95% CI 0.23 to 0.59, respectively), a bachelor's or master's degree (aOR = 0.64, 95% CI 0.50 to 0.82 and aOR = 0.66, 95% CI 0.48 to 0.89, respectively), and age groups 30-34 and 35-39 year-olds (aOR = 1.31, 95% CI 1.08 to 1.59 and aOR = 1.50, 95% CI 1.19 to 1.89, respectively).</p><p><strong>Conclusion: </strong>In this North Carolina population, high-risk pregnancy history was only modestly associated with postpartum use of high-efficacy contraception. Other findings of this study suggest that high efficacy postpartum contraception use is influenced by demographic, reproductive, and healthcare interaction factors beyond pregnancy risk status alone. Interventions focused on equitable, patient-centered counseling and access to postpartum contraception may improve reproductive planning among patients with high-risk pregnancies who desire pregnancy spacing or prevention.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819995","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":"Maternal Mental Health After Stillbirth: Associations With Autopsy Decisions, Cause of Death Knowledge, and Psychosocial Risk Factors.","authors":"Rana Jawish, Emily DiBlasi, Amanda A Allshouse, Renee Martin-Willett, Becky Kinkead, Matthew Moench, Paul J Carlson, Marcela C Smid, Adam J Gordon, Robert M Silver, Mark H Rapaport","doi":"10.1007/s10995-026-04314-8","DOIUrl":"https://doi.org/10.1007/s10995-026-04314-8","url":null,"abstract":"<p><strong>Purpose: </strong>Stillbirth is a traumatic event with potentially lifelong effects on maternal mental health, but there are few clinical guidelines or resources for supporting families. Additionally, the effects of parental autopsy decision-making and knowledge of cause of death effect on maternal mental health is unclear.</p><p><strong>Methods: </strong>We evaluated associations between autopsy decision, cause of death determination, and maternal mental health in data from the multi-center, five region Stillbirth Collaborative Research Network (2006-2008). Secondarily, we examined psychosocial risk factors associated with adverse MMH outcomes. Maternal mental health was assessed at single time point within 6-36 months after stillbirth delivery. Exposures included autopsy decision (none, partial, full) and knowledge of cause of death (known, unknown). Adverse maternal mental health was defined as abnormal scores on one or more validated instruments assessing depression, grief, distress, post-traumatic growth, and change in substance use. Psychosocial risk factors included childhood trauma and perceptions of support or blame. Logistic regression identified associations with maternal mental health outcomes.</p><p><strong>Results: </strong>Among 272 participants (44% response rate), 54% reported one adverse maternal mental health outcome 6-36 months postpartum. Autopsy decision and knowledge of cause of death did not impact maternal mental health. Knowledge of cause of death was associated with less feeling of blame (OR 2.02, 95% CI 1.05-3.88). Childhood trauma (OR 4.10, 95% CI 1.60-10.70) and low income (OR 2.32, 95% CI 1.34-4.02) were associated with poorer maternal mental health.</p><p><strong>Conclusions: </strong>Despite the impact of stillbirth on maternal health, our understanding of factors impacting mental health is limited, and the clinical guidelines for providing psychological care are limited. In the current study, autopsy decision and knowledge of cause of death did not impact mental health outcomes 6-36 months postpartum, while childhood trauma, feeling blamed for the loss, and socioeconomic disadvantage were significantly associated with adverse mental health. This important, early data from the Stillbirth Collaborative Research Network may help inform screening for psychosocial risk factors and updating guidelines for providing trauma-informed support following stillbirth.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799634","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: Perceived Tobacco Smoking Risk and Predictors of Smoking During Pregnancy: A Cross-Sectional Predictive Correlational Study.","authors":"Teresa Gulley, Denise Hammer, Melissa Jarvill, MyoungJin Kim, Sheila Jesek-Hale","doi":"10.1007/s10995-026-04315-7","DOIUrl":"https://doi.org/10.1007/s10995-026-04315-7","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766450","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":"Multivariate Analysis of Indicator-Specific Determinants of Childhood Malnutrition in Rajasthan, India: Evidence from NFHS-5.","authors":"Prashant Verma, Shagun Khare, Mukti Khetan, R Preetha","doi":"10.1007/s10995-026-04309-5","DOIUrl":"10.1007/s10995-026-04309-5","url":null,"abstract":"<p><strong>Background: </strong>Childhood malnutrition remains a major public health challenge with significant implications for child survival and development. Understanding the differential determinants of stunting, wasting, and underweight is essential for designing targeted interventions.</p><p><strong>Objective: </strong>To identify and analyze factors associated with stunting, wasting, and underweight among children under five years in Rajasthan, India, using data from the National Family Health Survey (NFHS-5, 2019-21).</p><p><strong>Methods: </strong>A cross-sectional study was conducted using data on 12,549 children aged 0-59 months. Nutritional outcomes were defined using the WHO Child Growth Standards. Multivariate logistic regression analyses were performed separately for stunting, wasting, and underweight to assess their associations with socio-demographic and maternal factors.</p><p><strong>Results: </strong>The prevalence of stunting, wasting, and underweight was 32.14%, 16.78%, and 25.71%, respectively. Female children had significantly lower odds of all three malnutrition indicators compared to males. Socioeconomic status was a consistent determinant, with children from poorer households exhibiting higher odds across all outcomes. Urban residence was associated with reduced odds of wasting, but not of stunting. Higher birth order was significantly associated with increased odds of stunting and underweight, but not wasting. Low birth weight was significantly associated with wasting and underweight, but not with stunting. Maternal education showed a protective effect only against underweight. Caste was associated with wasting and underweight but not stunting. No significant associations were observed for maternal anemia or maternal age at childbirth.</p><p><strong>Conclusions: </strong>Determinants of childhood malnutrition vary across stunting, wasting, and underweight, highlighting the need for indicator-specific interventions. Policies should focus on reducing socioeconomic inequalities, improving maternal education, and addressing risks associated with low birth weight to combat child malnutrition effectively.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726156","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 Effect of An Integrated Accountable Model on Healthcare Utilization During Pregnancy Among Low-Income Women with Comorbid Mental and Physical Conditions: Evidence from Oregon's Coordinated Care Organizations.","authors":"Mandana Masoumirad, S Marie Harvey, Linh N Bui, Jangho Yoon","doi":"10.1007/s10995-026-04312-w","DOIUrl":"10.1007/s10995-026-04312-w","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of chronic conditions continues to increase in the United States, disproportionately affecting low-income women and Medicaid beneficiaries. This study examined whether an accountable care approach implemented in Oregon Medicaid, known as Coordinated Care Organizations (CCOs), which integrates the delivery of physical and mental health services, may improve high-value healthcare utilization during pregnancy among female Oregon Medicaid beneficiaries with chronic mental-physical comorbidities (MPCs).</p><p><strong>Methods: </strong>We performed a retrospective analysis of Oregon Medicaid data from 2008 to 2016, linked with birth certificates and hospital discharge records. Measures of high-value utilization included timely and adequate prenatal care visits, preventable hospitalizations, and preventable emergency department (ED) visits. We utilized a quasi-experimental difference-in-differences approach, comparing the pre-post changes in the outcomes between CCO enrollees and other Medicaid beneficiaries.</p><p><strong>Results: </strong>CCO enrollment was associated with greater odds of having the first prenatal care visit in the first trimester of pregnancy (OR 1.51, CI 1.21, 1.88) and the adequacy of prenatal care (OR 1.40, CI 1.10, 1.78) among women with MPCs. However, no statistically discernible associations were found for preventable hospitalization and ED visits.</p><p><strong>Discussion: </strong>CCOs are effective in improving timely and adequate utilization of prenatal care among women with MPCs. Further research is needed to understand whether and how CCOs may reduce preventable costly healthcare utilization among women with MPCs during and beyond pregnancy.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725658","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}