Maternal and Child Health Journal最新文献

{"title":"Exploring the Multilevel Determinants of Suboptimal Maternal and Child Continuum of Care in Indonesia.","authors":"Vitri Widyaningsih, Itismita Mohanty, Tri Mulyaningsih, Tesfaye Alemayehu Gebremedhin, Riyana Miranti, Nurussyifa Afiana Zaen, Septyan Dwi Nugroho, Akhmad Azmiardi, Ari Probandari","doi":"10.1007/s10995-025-04110-w","DOIUrl":"10.1007/s10995-025-04110-w","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the multilevel factors associated with completeness of care across the continuum of maternal and child health is needed in order to reduce maternal and child mortality and morbidity in Indonesia. This study aims to assess the multilevel determinants of continuum of care (CoC) and its contextual factors in Indonesia.</p><p><strong>Methods: </strong>Data from the 2017 Indonesian Demographic and Health Survey were analyzed. A total of 14,398 women aged 15-49 years who had live births 5 years preceding the survey were analyzed for maternal CoC, while data from 9,206 women and their children (aged < 36 months) were analyzed for maternal CoC and vaccination. Maternal CoC include antenatal care visits, safe facility delivery, and postnatal care. Vaccination includes the 10 recommended dosages of vaccination adjusted for age. Multilevel logistic regression was used to analyse variations in maternal CoC at the individual, household and community levels.</p><p><strong>Results: </strong>Our findings showed that only half of the women in our study had the complete maternal CoC, and only one-third had both the complete CoC and vaccination for their children. The odds of completing CoC and vaccination are lower among women aged < 20 years, have ≥ 4 children, have low socioeconomic status, and live in rural areas or outside Java-Bali. Pregnancy-related factors were also associated with CoC completeness.</p><p><strong>Conclusions for practice: </strong>Targeted interventions to improve awareness and increase access that go beyond the individual factors should be developed. In addition to awareness campaigns, interventions aimed at reducing disparities across the different regions in Indonesia should be implemented to improve completeness of maternal CoC and vaccination.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"919-931"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561577","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":"Preconception Physical Activity and Maternal Health Outcomes: An Integrative Review of Studies from 2016-2025.","authors":"Kadeeja S Murrell, Rodney P Joseph","doi":"10.1007/s10995-025-04086-7","DOIUrl":"10.1007/s10995-025-04086-7","url":null,"abstract":"<p><strong>Introduction: </strong>Preconception physical activity may lower the risk of adverse maternal health outcomes. This integrative review examined the relationship between preconception physical activity and maternal health outcomes.</p><p><strong>Methods: </strong>Six electronic databases (i.e., Cochrane Library, PubMed, Science Direct, PsycInfo, SAGE Journals, and Sports Discus) were searched for relevant articles. Articles were eligible for inclusion if they were (1) published between January 1, 2016, and January 9, 2025, in an English-language peer-reviewed journal; (2) included a measure of preconception physical activity; and (3) reported maternal health outcomes during or after birth.</p><p><strong>Results: </strong>Search procedures retrieved a total of 3608 articles. After a thorough screening process, seven articles met the inclusion criteria of this review. Five articles reported data from prospective cohort studies, and two articles employed cross-sectional designs. Outcomes examined included gestational hypertension (n = 3), gestational diabetes/glucose metabolism (n = 4), preeclampsia (n = 2), infant birth weight (n = 2), pregnancy weight gain (n = 1), duration of pregnancy (n = 1), and mode of delivery (n = 1). Higher preconception physical activity engagement was linked to reduced risks of gestational hypertension (n = 1), gestational diabetes/glucose metabolism (n = 2), preeclampsia (n = 2), low birth weight (n = 1), excessive pregnancy weight gain (n = 1), and post-term delivery (n = 1). Three studies found greater risk reduction with increased moderate-to-vigorous physical activity.</p><p><strong>Discussion: </strong>Engaging in regular moderate-to-vigorous physical activity during preconception is associated with a reduced risk of numerous adverse maternal health outcomes.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"857-869"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659051","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 Experiences and Challenges in Breastfeeding Infants with Tongue-Tie: A Systematic Review.","authors":"Frances Rodriguez Lara, Jonathan M Carnino, Jessica R Levi","doi":"10.1007/s10995-025-04102-w","DOIUrl":"10.1007/s10995-025-04102-w","url":null,"abstract":"<p><strong>Introduction: </strong>Tongue-tie, clinically referred to as ankyloglossia, is a common condition characterized by an unusually short lingual frenulum and is associated with breastfeeding difficulties. Mothers of infants with tongue-ties are at increased risk of not only painful breastfeeding and poor latching, but also increased maternal stress and decreased maternal-infant bonding. The purpose of this systematic review is to examine the literature on maternal experiences and wellbeing while feeding infants with tongue-ties.</p><p><strong>Methods: </strong>We searched MEDLINE, Web of Science and EMBASE for relevant articles. Keywords \"maternal experience\" and \"tongue-tie\" were among those used. An independent review was conducted by two authors, and studies were included if they reflected maternal experiences beyond breastfeeding outcomes.</p><p><strong>Results: </strong>We found 8 studies, including qualitative and quantitative studies, that described maternal experiences with breastfeeding tongue-tied infants. All studies noted an increase in physiologic symptoms such as nipple pain and bleeding, as well as psychological symptoms including stress and strained relationships.</p><p><strong>Conclusions: </strong>Our systematic review indicates that women breastfeeding infants with tongue-ties are at increased risk of breastfeeding complications which can result in maternal stress, frustration, and impaired mother-infant bonding. Early evaluation of tongue-tie as a potentially significant contributor to breastfeeding complications and early intervention is important in these mothers and would likely decrease these negative effects described. Further research is needed to determine which populations are most likely to benefit from early intervention and how to best address the issue.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"870-878"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022349","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":"Social and Economic Correlates of Prenatal Depression in Rural Bangladeshi Women.","authors":"H M Laughlin, K Khan, F Rashid, A Scarbrough, J R Bick","doi":"10.1007/s10995-025-04087-6","DOIUrl":"10.1007/s10995-025-04087-6","url":null,"abstract":"<p><strong>Objective: </strong>Prevalence rates of perinatal depression are especially high among women living in lower-middle-income countries (LMICs) when compared to higher-income countries. This is especially true for women living in Bangladesh, an LMIC in South Asia, a country that has limited mental health infrastructure and high rates of poverty. Women living in rural, impoverished communities in Bangladesh have been identified as being at high risk for prenatal depression. However, there is limited understanding of variability of prevalence rates across rural communities. To address this gap in understanding, we examined prevalence rates and correlates of prenatal depression among women living in two rural Bangladesh communities, Matlab and Ariahizar.</p><p><strong>Methods: </strong>During a prenatal health care visit, 60 women in two rural communities in Bangladesh, completed a survey battery asking about household income, education, depression symptoms, autonomy over household technology, and financial decision-making ability.</p><p><strong>Results: </strong>On average, prenatal depression was experienced by 31.6%, of women enrolled in this study, although rates varied significantly across communities. Around 50% of all women in the higher-risk, more underserved, Arihaizar community experienced clinically significant symptoms of prenatal depression in comparison with only 13.3% of women who experienced clinically significant levels of prenatal depression in Matlab, a higher resourced rural community. Across both communities, perceived autonomy and independence (based on reports of having control over resources in the home) were associated with lower depression symptoms.</p><p><strong>Conclusions for practice: </strong>Prevalence of prenatal depression is highest in the most underserved communities. Additionally, we found preliminary associations between women's autonomy and depression during pregnancy.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"977-985"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732490","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":"Caring for A Child with Autism Spectrum Disorder: A Metaphor Study.","authors":"Betul Uncu, Ayse Irem Gokcek, Nehir Aras","doi":"10.1007/s10995-025-04114-6","DOIUrl":"10.1007/s10995-025-04114-6","url":null,"abstract":"<p><strong>Objective: </strong>It aims to explore the language used by women about their experiences of caring for their child with autism spectrum disorder through metaphor, and to provide a valuable source of insight for midwives and other clinicians.</p><p><strong>Methodology: </strong>The study was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews and observations of the participants. Data saturation was achieved after 11 participants were interviewed. Data were collected in a private clinic between January and May 2024.</p><p><strong>Results: </strong>This metaphor analysis revealed ten metaphors that mothers used to describe their experience of caring for their child with an autistic spectrum disorder. These metaphors were described as a treasure, a maze, a boat trip, a tangled knot, a newly discovered planet, a late bearing tree, a mountaintop, a new day, an alien and a newly sprouted flower.</p><p><strong>Conclusions: </strong>In conclusion, paying attention to the metaphors that women with children on the autistic spectrum use to describe their caring situation can provide midwives and other clinicians with rich insights into understanding women.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"892-899"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217251","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 Relationship Between Adherence to the MIND Diet and Maternal Anxiety and Sleep Disorders.","authors":"Afsane Bahrami, Zahra Zamaninasab, Zahra Khorasanchi, Asghar Zarban, Amir Hassan Asadian, Gordon A Ferns, Samira Karbasi","doi":"10.1007/s10995-025-04119-1","DOIUrl":"10.1007/s10995-025-04119-1","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal diet is essential for the mother's and infant's health. Our Study aimed to evaluate the relationship between breastfeeding mothers' psychological distress and the Mediterranean diet and Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet.</p><p><strong>Methods: </strong>The data were collected in a cross-sectional survey conducted by the authors in 2021. Psychological parameters were assessed in 350 breastfeeding mothers using the Quality of Life (QL) Questionnaire, Depression Scale, Anxiety Questionnaire, and Pittsburg Sleep Quality Index (PSQI). A Food Frequency Questionnaire (FFQ) assessed adherence to the MIND diet.</p><p><strong>Results: </strong>Mothers in the highest tertile of the MIND diet had significantly lower maternal sleep disturbance scores (3.71 ± 3.61 vs. 5.28 ± 3.89; P < 0.001), lower anxiety scores (30.86 ± 7.49 vs. 32.89 ± 7.90; P-value = 0.01) and better maternal mental health (21.58 ± 3.68 vs. 20.76 ± 3.15) compared to those in the lowest tertile. After controlling for potential confounders, adherence to the MIND pattern was associated with less maternal sleep disturbance (β = 0.89; 95%CI: 0.82-0.96).</p><p><strong>Conclusions: </strong>for practice. Adherence to the MIND diet is potentially associated with less sleep disturbance in breastfeeding mothers.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"954-961"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498469","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":"Heavy Metal Levels in Maternal Blood and Breast Milk and Associated Risk Factors.","authors":"Didem Kaymak, Orhan Atakol, Nurcan Acar, Sevi Öz, Rahime Bedir Fındık, Özlem Moraloğlu Tekin","doi":"10.1007/s10995-025-04140-4","DOIUrl":"10.1007/s10995-025-04140-4","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"962-976"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620910","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":"Experiences of Lactation in GME: Are there Benefits Beyond the Parent and Infant?","authors":"Virginia Sheffield, Sarah Tomlinson, Harlan McCaffery, Amanda D McCormick","doi":"10.1007/s10995-025-04115-5","DOIUrl":"10.1007/s10995-025-04115-5","url":null,"abstract":"<p><strong>Introduction: </strong>Although lactating graduate medical education trainees often encounter barriers when returning to work-such as perceived challenges on clinical teams-the potential benefits arising from their lactation experiences remain understudied. In particular, no prior research has examined whether working alongside lactating trainees enhances knowledge and patient care. The purpose of this study was to assess trainee perceptions of how experiences with lactation impacted their knowledge of lactation and ability to care for lactating patients.</p><p><strong>Methods: </strong>In 2022, all residents and fellows at a large academic medical center were eligible to participate in an anonymous electronic survey. Data analyses included chi-squared testing of lactation experiences and trainee self-perceived ability to care for lactating patients.</p><p><strong>Results: </strong>133/1319 (10%) of trainees representing 31 programs completed the survey. 87% of participants disagreed that they felt uncomfortable about a co-resident pumping in their presence. Personal experience with lactation was associated with perceived increase in knowledge of lactation (p = 0.012) as well as perceived ability to better care for a lactating patient (p < 0.001) when compared with no experience with lactation, or experience through others. Among those without personal lactation experience, 71% felt their knowledge of lactation improved and 42% believed their ability to care for lactating patients was better due to their experiences working with lactating teammates.</p><p><strong>Conclusions: </strong>Lactation does not disrupt other residents on the team and may positively impact the care of lactating patients. The benefits of lactation may extend beyond the lactating parent and their infant.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"887-891"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327208","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":"Language-Based Inequities in Transfusion Practices with Obstetric Hemorrhage.","authors":"Alexa Cohen, Samantha Goulding, Carly Pickett, Beatrice Lynch, Osaro Obanor, Melissa Peskin-Stolze, Pe'er Dar, Georgios Doulaveris","doi":"10.1007/s10995-025-04118-2","DOIUrl":"10.1007/s10995-025-04118-2","url":null,"abstract":"<p><strong>Objectives: </strong>Inequities in race, ethnicity and socioeconomic status have been well documented in postpartum hemorrhage (PPH) and hemorrhage-associated morbidity. However, little is known about the impact of language barriers on maternal outcomes in PPH. Our study aim was to investigate language-based inequities in maternal outcomes among gravidas with PPH.</p><p><strong>Methods: </strong>This is a retrospective cohort of patients with PPH who delivered at an urban academic institution between January 2020 and December 2022. Maternal language is categorized as English primary language (EPL) or non-English primary language (NEPL). PPH is defined as a quantitative blood loss (QBL) greater than 1000 mL within 24 h of delivery. QBL is a calculated measurement of peripartum and postpartum blood loss. Primary outcome is transfusion of packed red blood cells (pRBC). Secondary outcomes include transfusion of 4 + units of pRBC, disseminated intravascular coagulation (DIC) and admission to intensive care unit (ICU). Multivariable logistic regression was used to estimate the association of primary language with maternal outcomes.</p><p><strong>Results: </strong>1723 patients with PPH were included: 1314 (76.3%) with EPL and 409 (23.7%) with NEPL. English-speaking and non-English speaking patients had similar QBL rates (1530.2 ± 634.2 vs 1496.0 ± 668.1, p = 0.3). However, transfusion rates were lower in those with NEPL, when compared to EPL (28.2% vs 22.9%, p = 0.039). After adjusting for age, race/ethnicity, nulliparity, body mass index, pre-eclampsia and pre-delivery anemia, gravidas with NEPL were less likely to be transfused compared with EPL (aOR 0.7, 95% CI 1.012-1.806, p = 0.04). Rates of DIC, ICU admission and transfusion of 4 + units of pRBC were similar between groups. CONCLUSIONS FOR PRACTICE: Despite a similar postpartum blood loss, patients with NEPL had lower rates of blood transfusion in PPH compared to patients with EPL. Further research is needed in health literacy and language proficiency that may impede access to transfusion in patients with PPH.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"948-953"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585324","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":"Improving Access to Mental Health Care among Children who Receive Subspecialist Care.","authors":"Kristin Hittle Gigli, Genevieve Graaf","doi":"10.1007/s10995-025-04116-4","DOIUrl":"10.1007/s10995-025-04116-4","url":null,"abstract":"<p><strong>Objectives: </strong>Children and Youth with Special Healthcare Needs (CYSHCN) have high rates of unmet health care need, particularly mental health. To increase access to mental health care, policymakers support pediatric subspecialists providing mental health care. Yet it is unclear how great the need for this role might be. This study described mental health care needs among CYSHCN who needed pediatric subspeciality care, and rates at which needs go unmet.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 20,335 CYSHCN who needed subspecialist care from 2016 to 2021 using pooled National Survey of Children's Health data. Analysis described rates of mental health care need and unmet need.</p><p><strong>Results: </strong>40% (N = 8,538) of CYSHCN who needed subspecialist care had mental health care needs. CYSHCN receiving care from a specialist had a significantly lower unmet need for mental health care, compared to those who did not receive specialist care (12.5% vs. 43.5%). Receiving subspecialist care was associated with a 24-percentage point decrease in unmet mental health need.</p><p><strong>Conclusions for practice: </strong>CYSHCN who receive subspecialist care have high rates of mental health care need, most need is met. Future work should explore strategies to support subspecialists in the provision of holistic, physical, and mental, health care without assuming roles as mental health care providers.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"879-886"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508903","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}