Maternal and Child Health Journal最新文献

{"title":"Longitudinal Associations Between Cannabis Use during Pregnancy and Child Cognitive, Motor, and Language Development at 2 Years Old.","authors":"Justine Pleau, Noémie Tanguay, Yohann Courtemanche, Jean R Séguin, Catherine M Herba, Marie-Noelle Simard, Andrea A N MacLeod, William D Fraser, Gina Muckle","doi":"10.1007/s10995-025-04077-8","DOIUrl":"10.1007/s10995-025-04077-8","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this study are to describe cannabis use during pregnancy, identify associated factors, examine the associations between prenatal cannabis use and the cognitive, motor and language development of 2-year-old children, and determine whether these associations differ according to child sex.</p><p><strong>Methods: </strong>Data from 1489 mother-infant dyads from the 3D prospective pregnancy and birth cohort Study (2010-2012) were used. Prenatal cannabis use was measured during interviews in each trimester of pregnancy. Cognitive and motor development were assessed by The Bayley Scales of Infant and Toddler Development (BSID-III) and language development by the MacArthur-Bates Communicative Development Inventories at 2 years of age. Multiple linear regressions and differential analyses by child sex were performed.</p><p><strong>Results: </strong>2.6% of women reported using cannabis during pregnancy, the majority of whom stopped after the first trimester. Prenatal cannabis use was associated with lower socioeconomic status, prenatal use of alcohol and tobacco, and more distress symptoms during the first trimester of pregnancy. Results showed no significant associations between prenatal cannabis use (yes/no) and developmental indicators (Cognitive: B = 0.016, 95% CI [-0.268, 0.299]; Fine motor: B = 0.029, 95% CI [-0.271, 0.328]; Gross motor: B = 0.060, 95% CI [-0.143, 0.544]; Language: B = 0.200, 95% CI [-0.229, 0,465]). Contrary to our hypothesis, a positive association between cannabis use and language development was found in girls only.</p><p><strong>Conclusion: </strong>The study, consisting of a large sample and developmental indicators independent of parental assessment, highlights the need for more studies on prenatal cannabis exposure documented by biomarkers.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"549-562"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694178","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":"Public Insurance Eligibility Thresholds and Receipt of Mental Health Services among Childen from Households with Low Incomes.","authors":"Yidan Xue Zhang, Adam S Wilk, Janet R Cummings","doi":"10.1007/s10995-025-04074-x","DOIUrl":"10.1007/s10995-025-04074-x","url":null,"abstract":"<p><strong>Introduction: </strong>Only half of U.S. children with mental health conditions receive treatment annually, and children from lower-income households face greater barriers to treatment. Medicaid and the Children's Health Insurance Program (CHIP) facilitate children and families to access mental health services by providing government-funded insurance coverage. However, household income eligibility thresholds for children in Medicaid and CHIP vary greatly across states, and children from low-income households in states with a higher threshold are more likely to access healthcare. Using national data, we examine the relationship between eligibility thresholds across Medicaid and CHIP and receipt of mental health services among children from low-income households.</p><p><strong>Methods: </strong>We used data from the 2016-2020 National Survey of Children's Health to identify children ages 6-17 with household incomes below 400% of the federal poverty line. We conducted multivariable logistic regressions to estimate the associations between eligibility thresholds and children's (1) use of any mental health services as well as (2) caregiver-reported unmet mental health need in the past year.</p><p><strong>Results: </strong>Controlling for child, family, and state characteristics, we did not find a significant relationship between eligibility thresholds and use of any mental health services. However, we found that a one standard deviation increment in the eligibility threshold above the mean was associated with 20% lower odds of caregiver-reported unmet mental health need (OR: 0.79, p < 0.01).</p><p><strong>Discussion: </strong>More generous eligibility thresholds in Medicaid and CHIP are associated with less unmet need for mental health care among children from families with low incomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"527-536"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804567","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":"A Brief Report of Self-Care Practices and Respite Use Among Hispanic/Latina Mothers of Children with Developmental Disabilities.","authors":"Jessica Gutierrez, Athena K Ramos","doi":"10.1007/s10995-025-04081-y","DOIUrl":"10.1007/s10995-025-04081-y","url":null,"abstract":"<p><strong>Introduction: </strong>Caring for a child with disabilities is challenging and sometimes overwhelming. Self-care and use of respite services can be important strategies for caregivers to relieve stress, prevent burnout, and reduce the risk of poor physical and mental health. Little is known about the use of self-care and respite care services among Hispanic/Latino caregivers of children with developmental disabilities.</p><p><strong>Objectives: </strong>The purpose of this study was to identify: (1) if Hispanic/Latina mothers of children with developmental disabilities in Nebraska practiced self-care or used respite support services, (2) what types of self-care practices were used, and (3) what if anything prevented these mothers from practicing self-care or using respite services.</p><p><strong>Methods: </strong>A total of 75 Hispanic/Latina mothers were interviewed between August-September 2022.</p><p><strong>Results: </strong>We found that 73.3% of participants reported practicing self-care, but even more (80%) reported engaging in specific self-care activities. Participants who were living in the United States without legal permission were significantly less likely to report practicing self-care compared to those who were U.S. citizens, residents, or were in process for residency (38.2% vs. 61.8%), p = .02. Only 6.8% of participants reported using respite services. Of those who did not use respite services, 60% reported that they did not know about such services.</p><p><strong>Conclusions for practice: </strong>Promoting the availability of supportive resources for caregivers in culturally, linguistically, and contextually relevant formats (especially those that are available regardless of immigration status) could be valuable. Institutionalizing caregiver navigation programs and addressing cultural and structural barriers to respite service uptake could have positive benefits for caregivers of children with disabilities.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"441-448"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732438","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":"Profiles of Family Stressors Among Low-Income Families with Young Children.","authors":"Laura M Justice, Britt Singletary, Hui Jiang, Kammi K Schmeer","doi":"10.1007/s10995-025-04061-2","DOIUrl":"10.1007/s10995-025-04061-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined profiles of family stressors, based on the five dimensions of the Family Stress Model (economic hardship, economic pressure, parental psychological distress, interparental relationship problems, and disrupted parenting) among low-income families with young children. We aimed to validate the model with a sample of low-income families and then to determine whether there were reliable profiles of families on the five dimensions.</p><p><strong>Methods: </strong>Mothers completed questionnaires when children were between six and 15 months old to capture background information and 14 key indicators of the five Family Stress Model dimensions. Our analytical sample comprised 353 families that provided data for at least one key indicator. We conducted confirmatory factor analysis (CFA) to statistically validate the Family Stress Model, then explored distinct profiles using latent profile analyses (LPA), and examined how profile membership correlated with family characteristics.</p><p><strong>Results: </strong>CFA model fit indices indicated a good fit of the data relative to the theoretical model. LPA revealed three distinct profiles of stressor among families, consistent with low, medium, and high patterns of stressors. Families in the high-stress profile experienced larger household numbers, higher maternal loneliness, reduced social connectedness, and higher reports of unplanned pregnancy.</p><p><strong>Conclusions for practice: </strong>Findings show applicability of the Family Stress Model to low-income families with young children, and indicate that these families are diverse in terms of the stressors they experience, characterized by three distinct profiles. In this regard, low-income families should not be viewed monolithically, but rather as experiencing variability in the stressors they face.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"483-493"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homelessness and Birth Outcomes in the Pregnancy Risk Assessment Monitoring System, 2016-2020.","authors":"Ashley A Meehan, Megan Steele-Baser, Aliza M Machefsky, Cynthia H Cassell, Martha P Montgomery, Emily Mosites","doi":"10.1007/s10995-025-04053-2","DOIUrl":"10.1007/s10995-025-04053-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to estimate the prevalence of homelessness shortly before or during pregnancy and describe differences in maternal characteristics and adverse birth outcomes between people reporting homelessness and not reporting homelessness.</p><p><strong>Methods: </strong>We used 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 31 sites to estimate the prevalence of self-reported homelessness during the 12 months before giving birth. We used logistic regression models to evaluate the association between homelessness and adverse birth outcomes, specifically small for gestational age (SGA), low birth weight (LBW), and preterm birth (PTB).</p><p><strong>Results: </strong>Of 138,603 respondents, 4,045 reported homelessness, representing 2.4% of weighted respondents. Respondents reporting homelessness differed from respondents who did not report homelessness in maternal demographic characteristics, health conditions, behavioral and environmental risk factors, and adequacy of prenatal care. In unadjusted models, homelessness was associated with higher prevalences of SGA, LBW, and PTB (PR 1.38, 95% CI 1.21-1.57; PR 1.73, 95% CI 1.56-1.91; PR 1.42, 95% CI 1.25-1.61; respectively). After adjusting for maternal age, race and ethnicity, education, BMI, and cigarette smoking, prevalence ratios were attenuated and no longer significant.</p><p><strong>Conclusions for practice: </strong>Although homelessness was not independently associated with adverse birth outcomes in adjusted models, people reporting homelessness before or during pregnancy represent a group at increased risk of inadequate health care utilization and adverse birth outcomes due to other underlying demographic and social factors. Health care providers can play a critical role in identifying if patients may be experiencing homelessness and facilitating connections to social support.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"472-482"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984954","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 Infant-Mother Room-Sharing and Symptoms of Postpartum Depression: A Population-Based Study.","authors":"Sravya Patibandla, Zelalem T Haile","doi":"10.1007/s10995-025-04073-y","DOIUrl":"10.1007/s10995-025-04073-y","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to (1) examine the relationship between infant-mother room-sharing and postpartum depression (PPD) symptoms and (2) determine whether the relationship between infant-mother room-sharing and PPD symptoms varies by other maternal or infant characteristics.</p><p><strong>Methods: </strong>This cross-sectional study utilized de-identified secondary data from the 2016-2019 Pregnancy Risk Assessment and Monitoring System (PRAMS) (N=105,144). Frequencies and percentages were used to describe the characteristics of the study sample. Rao-Scott chi-square tests were used to examine differences in PPD symptoms and infant-mother room-sharing by maternal and infant characteristics. Multivariable logistic regression was performed to examine the independent association between infant sleeping arrangements and PPD symptoms. Pairwise interaction between infant sleeping arrangement and each covariate were included in the regression model, and stratified analyses were performed for variables with significant pairwise interactions.</p><p><strong>Results: </strong>The prevalence of PPD symptoms was 11.7%, and 79.5% reported that their infant sleeps in the same room. Significant pairwise interactions were found between infant-mother room-sharing and marital status, education, insurance, and receipt of WIC food assistance on PPD symptoms. The odds of having PPD symptoms were higher in those whose infants shared the same room compared to those whose infants slept in a different room. However, the observed association was present only in the subgroups of participants who were married, had greater than a high school level of education, had private insurance, and did not receive WIC food assistance during pregnancy.</p><p><strong>Conclusions for practice: </strong>Findings suggest that infant-mother room-sharing is independently associated with increased odds of PPD symptoms.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"515-526"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Prenatal Alcohol Exposure History for Pediatric Patients: Practices Among U.S. Clinicians.","authors":"Janae Dunkley, Nicholas P Deputy, Clark H Denny, Jacquelyn Bertrand, Shana Godfred-Cato, Shin Y Kim","doi":"10.1007/s10995-024-04015-0","DOIUrl":"10.1007/s10995-024-04015-0","url":null,"abstract":"<p><strong>Objectives: </strong>The American Academy of Pediatrics recommends clinicians who treat pediatric patients screen for prenatal alcohol exposure (PAE) to facilitate the identification of children with fetal alcohol spectrum disorders and promote timely access to behavioral and cognitive interventions. We evaluated how frequently clinicians inquire about PAE in their pediatric patient interactions and the methods used to ascertain this information.</p><p><strong>Methods: </strong>We analyzed data from the Fall 2020 DocStyles survey, a web-based survey of primary healthcare professionals (n = 1754). Distributions for frequency of assessing PAE history for five pediatric populations and the methods used were calculated by clinician specialty (family practitioners [FP], pediatricians, and nurse practitioners/physician assistants [NP/PAs]) and overall. Chi-square and Bonferroni post-hoc tests determined whether frequency of assessing PAE history varied by specialty.</p><p><strong>Results: </strong>Among 779 clinicians serving pediatric patients, approximately 70.5%, 63.0%, and 60.7% reported often/always obtaining PAE history from parents of children with developmental/behavioral issues, adopted/foster children, and newborns, respectively. By contrast, less than half of respondents reported often/always collecting this information from parents of infants (47.6%) and new patients (38.2%). Most respondents reported collecting PAE history through interviews conducted by physicians or physician assistants (69.7%). Obtaining PAE history varied by specialty; pediatricians (71.5%) were more likely to collect PAE history for adopted/foster children when compared to FPs (57.7%, p = 0.003).</p><p><strong>Conclusions for practice: </strong>PAE history is not routinely obtained for pediatric patients. These findings highlight the need for trainings and practice supports to aid clinicians in identifying and treating children at-risk of FASDs.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"449-456"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequate Prenatal Care and Maternal Morbidity Among Birthing People with Preexisting Comorbidities.","authors":"Laura Chaves Cerdas","doi":"10.1007/s10995-025-04069-8","DOIUrl":"10.1007/s10995-025-04069-8","url":null,"abstract":"<p><strong>Introduction: </strong>Preexisting comorbidities can make the pregnancy experience difficult. Prenatal care has been suggested as a mechanism to identify and control preexisting conditions and prevent adverse maternal outcomes. Maternal morbidity encompasses health conditions attributed to and/or aggravated by pregnancy and childbirth that negatively impact the birthing person's well-being.</p><p><strong>Methods: </strong>Using North Carolina's birth records for 2011-2019, this analysis employs multivariate logistic regression to examine whether adequate prenatal care reduces the likelihood of maternal morbidity outcomes. The analysis examines both the overall birthing population (n = 1,020,639) and the birthing population with preexisting diabetes and/or hypertension (n = 29,230).</p><p><strong>Results: </strong>Having inadequate prenatal care increases the probability of experiencing maternal morbidity outcomes by 7.2% (OR = 1.072, 95%CI:1.01-1.13) compared to having adequate prenatal care. The effect is more pronounced among individuals with preexisting diabetes and/or hypertension, where having inadequate prenatal care increases the probability of maternal morbidity outcomes by 45.6% (OR = 1.456, 95% CI: 1.03-2.07) compared to those with adequate prenatal care.</p><p><strong>Discussion: </strong>These results suggest that adequate prenatal care may help prevent maternal morbidity outcomes across the birthing population, with particularly strong protective effects for those with preexisting conditions.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"504-514"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494269","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":"Evaluating Associations Among Maternal ACEs, Perinatal Depression, and Infant Experiences of Adversity.","authors":"Samantha Addante, Lucia Ciciolla, Amanda Baraldi, Karina M Shreffler","doi":"10.1007/s10995-025-04079-6","DOIUrl":"10.1007/s10995-025-04079-6","url":null,"abstract":"<p><strong>Objective: </strong>The growing literature on the intergenerational transmission of childhood adversity highlights the need to identify potential mechanisms underlying the relationship between maternal and infant adversity. This study examines prenatal and postpartum depressive symptoms as mediators between maternal ACEs and postpartum infant experiences of adversity.</p><p><strong>Methods: </strong>A diverse sample of 168 low-income, pregnant women (39% white) were recruited from urban prenatal clinics and followed for one-year post childbirth. Maternal childhood adversity and prenatal depressive symptoms were assessed during pregnancy, postpartum depressive symptoms were assessed at 6 months postpartum, and infant experiences of adversity at 12 months postpartum.</p><p><strong>Results: </strong>The total indirect effect of maternal ACEs on infant experiences of adversity through prenatal and postpartum depressive symptoms was significant, indicating that these symptoms collectively mediate this relationship. Additionally, our results demonstrated a mediated pathway in which maternal ACEs contributed directly to prenatal depression, which in turn indirectly influenced postpartum depression and infant experiences of adversity.</p><p><strong>Conclusion: </strong>Findings provide evidence for perinatal depressive symptoms as a potential mechanism that influences infant exposure to adverse experiences. Future research should explore these pathways in larger, more robust samples to clarify the role of postpartum depressive symptoms.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"563-571"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"494-503"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006267/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}