Maternal and Child Health Journal最新文献

{"title":"In Appreciation of the Maternal and Child Health Journal's Peer Reviewers, 2024.","authors":"","doi":"10.1007/s10995-025-04064-z","DOIUrl":"https://doi.org/10.1007/s10995-025-04064-z","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068932","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":"Folate and Vitamin B12 Status among Non-Pregnant, Non-Lactating Women of Reproductive Age and Predicted Risk for Neural Tube Defects, Morogoro Region, Tanzania.","authors":"Cara T Mai, Kaitlyn Long, Tedson Lukindo, Shameem Jabbar, John Gwakisa, Jorge Rosenthal, Mindy Zhang, Lorraine F Yeung, Amy Fothergill, Arick Wang, Kaunara Azizi, Dorah Chilumba, Jennifer L Williams, Christine M Pfeiffer, Elise Caruso, Germana H Leyna, Rogath Kishimba","doi":"10.1007/s10995-025-04046-1","DOIUrl":"https://doi.org/10.1007/s10995-025-04046-1","url":null,"abstract":"<p><strong>Introduction: </strong>Population risk for neural tube defects (NTDs) can be determined using red blood cell (RBC) folate. However, a paucity of biomarker and surveillance data among non-lactating, non-pregnant women of reproductive age (NPWRA) from Africa limits accurate assessment. Our study assessed folate and vitamin B12 status among non-lactating NPWRA and predicted population risk of NTDs in Tanzania.</p><p><strong>Methods: </strong>A cross-sectional biomarker survey of non-lactating NPWRA (15-49 years) in the Morogoro region, Tanzania was conducted during June-October 2019. Questionnaire interview responses and non-fasting blood samples were collected. Folate was assessed using the CDC microbiologic assay kit and vitamin B12 was measured using an electrochemiluminescence immunoassay. Complex survey design analyses were conducted using SAS-callable SUDAAN (v11.0.1).</p><p><strong>Results: </strong>Of the 761 participating non-lactating NPWRA, 294 (39.8%) had RBC folate insufficiency (<748 mol/L). The prevalence of RBC folate insufficiency was lower among non-lactating NPWRA living in urban than rural areas (PR: 0.72, 95% CI: 0.52-0.99) but did not differ by age or household wealth index. Vitamin B12 insufficiency was uncommon (< 221 pmol/L, 2.7%). The estimated NTD risk was 10.5 (95% uncertainty interval: 8.1-13.3) per 10,000 births.</p><p><strong>Discussion: </strong>Elevated NTD risk was predicted in the Morogoro region of Tanzania, where ∼ 40% of non-lactating NPWRA had RBC folate insufficiency and < 3% had vitamin B12 insufficiency. The NTD risk is consistent with surveillance data for the area, limited folic acid fortification of staple foods, and low vitamin B12 insufficiency. Further studies are needed to better understand the context of these findings, especially the impact of micronutrient fortification in Tanzania.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025246","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":"Comparison of Random Forest and Stepwise Regression for Variable Selection Using Low Prevalence Predictors: A case Study in Paediatric Sepsis.","authors":"Patricia Gilholm, Paula Lister, Adam Irwin, Amanda Harley, Sainath Raman, Luregn J Schlapbach, Kristen S Gibbons","doi":"10.1007/s10995-025-04038-1","DOIUrl":"https://doi.org/10.1007/s10995-025-04038-1","url":null,"abstract":"<p><strong>Introduction: </strong>Variable selection is a common technique to identify the most predictive variables from a pool of candidate predictors. Low prevalence predictors (LPPs) are frequently found in clinical data, yet few studies have explored their impact on model performance during variable selection. This study compared the Random Forest (RF) algorithm and stepwise regression (SWR) for variable selection using data from a paediatric sepsis screening tool, where 18 out of 32 predictors had a prevalence < 10%.</p><p><strong>Methods: </strong>Variable selection using RF was compared to forward and backward SWR. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), and the variables retained. Additionally, a simulation study assessed how increasing the prevalence of the predictors impacted the variable selection results.</p><p><strong>Results: </strong>The best fitting RF and SWR models retained were 22, and 17 predictors, respectively, with 14 and 10 predictors having a prevalence < 10%. Both the RF and SWR models had similar predictive performance (RF: AUC [95% Confidence Interval] 0.79 [0.77, 0.81], LR: 0.80 [0.78, 0.82]). The simulation study revealed differences for both RF and SWR models in variable importance rankings and predictor selection with increasing prevalence thresholds, particularly for moderately and strongly associated predictors.</p><p><strong>Discussion: </strong>The RF algorithm retained a number of very low prevalence predictors compared to SWR. However, the predictive performance of both models were comparable, demonstrating that when applied correctly and the number of candidate predictors is small, both methods are suitable for variable selection when using low prevalence predictors.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984933","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-15","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":"Examining the Impact of Integrated Obstetric Simulation Training on the Quality of Antenatal Care in Northern Ghana.","authors":"Ntemena Kapula, Osamuedeme J Odiase, Helen H Habib, Muna Bashir, Raymond Aborigo, Patience A Afulani","doi":"10.1007/s10995-024-04024-z","DOIUrl":"10.1007/s10995-024-04024-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess if an integrated simulation-based training on respectful maternity care (RMC) and management of obstetric and neonatal emergencies could improve the quality of antenatal care (ANC).</p><p><strong>Methods: </strong>The data are from two cross-sectional surveys administered in the East Mamprusi District of Northern Ghana in 2017 to evaluate the impact of integrated simulation-based training for healthcare providers. Surveys were administered to two groups of women aged 15-49 who delivered in a health facility before (baseline; n = 266) and 6 months after (end-line; n = 320) the intervention began. We assessed the quality of antenatal care pre- and post-training across two dimensions: service provision and experience of care. Analyses included linear and logistic regression.</p><p><strong>Results: </strong>Women in the end-line group reported higher quality of antenatal care than those in the baseline group. The average ANC experience of care score increased by 10 points at the end-line (Coeff = 10.3, 95%CI: 9.0,11.6), whereas the mean ANC service provision score increased by three points (Coeff = 2.6, 95% CI: 2.2, 3.1). End-line participants were more likely to have an ultrasound (OR: 24.1, 95%CI: 11.5, 50.3). Parity, tribe, education, employment, partner occupation, six or more antenatal visits, ANC facility, and provider type were also associated with ANC quality.</p><p><strong>Conclusions: </strong>Integrated simulation-based training for health providers has the potential to improve the quality of ANC. Incorporating such training into continuing professional development courses will aid global efforts to increase the quality of care throughout the maternity continuum of care.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"95-107"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689282","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":"Interventions to Enhance Facility Deliveries in Low- and Middle-Income Countries: A Scoping Review.","authors":"Etsuko Nishimura, Kaori Ochiai, Erika Ota","doi":"10.1007/s10995-024-04032-z","DOIUrl":"10.1007/s10995-024-04032-z","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this review were to identify and map evidence of interventions to enhance facility deliveries in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>A search for all relevant existing reports in the literature was conducted in December 2020 using the following online bibliographic databases: PubMed, EMBASE, and CENTRAL. A manual search of the reference lists of relevant systematic reviews and all identified studies was performed to identify additional studies. Two reviewers independently screened the titles and abstracts of the retrieved studies, and then screened the full text identified as inclusion in the initial screening.</p><p><strong>Results: </strong>The search of electronic databases and hand searching identified a total of 6682 articles. A total of 40 reports were identified for full-text review, and 31 reports were excluded. Finally, nine trials were included in the scoping review, and a total of 29,892 women were included in this review. Of nine trials, one was conducted in Nepal, and the other eight trials were performed in Africa: Kenya, Uganda, Nigeria, Tanzania, and Zambia. Our review found the following effective interventions to enhance facility deliveries: group antenatal care (ANC), birth plans, full vouchers, conditional cash transfers (CCTs), non-monetary incentives, and short message service (SMS).</p><p><strong>Conclusion: </strong>Women who received group ANC, promotion of birth plans, full vouchers, CCTs, non-monetary incentives, and SMS were significantly more likely to deliver at a facility.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"31-47"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792611","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":"Pediatric Subspecialist Referrals to Peer Support for Families.","authors":"Edward L Schor, Tali Klima, Holly K M Henry, Allison Gray, Megumi J Okumura","doi":"10.1007/s10995-024-04033-y","DOIUrl":"10.1007/s10995-024-04033-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Families of children with special health care needs (CSHCN) have reported to benefit from social, emotional, and informational support from other families (peer support) with similarly affected children. Pediatric subspecialists often serve as the primary medical providers for CSHCN, as well as educators for these children's families. The extent to which subspecialists refer families to sources of peer support is unknown.</p><p><strong>Methods: </strong>A statewide online survey of California pediatric subspecialists investigated opinions about the potential value and challenges of peer support. Data was obtained on the frequency with which families in their practices were referred to peer support, practice characteristics, and personal demographics. Weighted data, descriptive statistics, and regression models were used to characterize and predict factors affecting referral services.</p><p><strong>Results: </strong>There were 388 respondents, a response rate of 14.5%. Subspecialists were generally unfamiliar with peer support resources in their communities, but many more knew of peer support programs in their institutions. Most (> 85%) held positive views about peer support, though only 40% of practices often referred families for such support. Individual opinions did not predict practice referral processes for peer support which were more influenced by knowledge of resources, and availability of time, staffing, and institutional peer support resources.</p><p><strong>Conclusion: </strong>Offering referral to peer support services is compatible with pediatric subspecialty care. Educating physicians about available resources, assigning responsibility, providing staff time for referring families, and incorporating parent mentors into subspecialty practices can increase access. Future studies of families' referral experiences are needed.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"57-66"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814631","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":"Information Sharing to Enhance Early Childhood Services.","authors":"Deborah G Badawi, Otonyemiete Georgewill, Felicia Jones","doi":"10.1007/s10995-024-04025-y","DOIUrl":"10.1007/s10995-024-04025-y","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate stakeholder willingness to share information among various social service providers, and to determine perceived barriers to accessing these services in our state.</p><p><strong>Description: </strong>The Maryland Family Network and the Maryland Chapter, American Academy of Pediatrics partnered to collect information on family information sharing preferences and barriers to services. We received 22 Survey Monkey responses and had 41 focus group participants aged 25 to 44 years and all regions of the state were represented. Nearly half of participants were Black or African American and participants indicated a broad range of family income.</p><p><strong>Assessment: </strong>Most participants were a part of multiple assistance programs and were comfortable with all their information being shared, except their social security number. One third of participants noted they did not face barriers to accessing services. The other two thirds noted confusing applications, technology limitations and the need for self-advocacy as significant barriers.</p><p><strong>Conclusion: </strong>Families are very comfortable sharing information among early childhood service providers, and in fact favor having a single basic application that allows them to check off the agencies to which they would like to apply. Barriers to accessing services are logistical as well as cultural.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"12-16"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717456","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 Unmet Needs in Health Care and Social Services and Exposure to Violence Among Parents.","authors":"Marianne Sipilä, Mika Helminen, Tuovi Hakulinen, Eija Paavilainen","doi":"10.1007/s10995-024-04021-2","DOIUrl":"10.1007/s10995-024-04021-2","url":null,"abstract":"<p><strong>Objective: </strong>Existing research has shown that parental exposure to violence has negative consequences on health outcomes, but the effect of such exposure on unmet health care and social service need is unknown. This study aims to investigate the association between unmet health care and social services and parental violence exposure among parents with children.</p><p><strong>Study design: </strong>This study used the data of 6289 parents aged 18-60 years who had at least one child under 18 years living in the same household. Parental violence exposure was measured. Unmet child and adult health care and social service need was operationalized through questions on the services needed, those that had not been received, and those that were considered inadequate.</p><p><strong>Results: </strong>Parents who experienced any kind of violence had more unmet service need. There were more women among parents with violence experience (65.4%) than those with no violence experience (51.9%). Violence experience increased the odds of unmet need for general adult healthcare services (OR 2.02, CI 1.64-2.57), maternity and child health clinics (OR 2.52, CI 2.00-3.18), family guidance clinics and home help (OR 2.38, CI 1.60-3.54), mental health or child welfare services (OR 2.05, CI 1.52-2.75), and school health care (OR 1.99, 1.50-2.65). After adjusting for sociodemographic factors, the associations between exposure to violence experience and unmet needs for healthcare and social services remained statistically significant.</p><p><strong>Conclusion: </strong>Violence in close relationships profoundly impacts health and well-being. By addressing unmet health care needs and supporting parents, we can break the cycle of violence and promote better mental health outcomes. Preventive policies and early interventions are essential to mitigate the consequences of violence in families.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"114-125"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751964","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":"The Early Infancy of a Parent and Baby Mental Health Unit: A Reflection.","authors":"Sophie Isobel, Alison Green, Sylvia Lim-Gibson","doi":"10.1007/s10995-024-04027-w","DOIUrl":"10.1007/s10995-024-04027-w","url":null,"abstract":"<p><strong>Purpose: </strong>This article describes the experience of establishing a new parent and baby mental health unit, including challenges in the first year of operation. The article aims to narrate the experience for the purpose of informing other new mental health services and contributing to service development knowledge.</p><p><strong>Description: </strong>The analogy of the early infancy period is used to highlight the parallel process of adjustment, confidence and identity formation occurring as part of the unit development and by the parents who are admitted.</p><p><strong>Assessment: </strong>Key challenges are presented as \"We had a baby and moved house at the same time\", \"We had a baby with someone we just met\", \"We had ghosts in our communal nursery\" and \"We were juggling the baby and the bathwater\".</p><p><strong>Conclusion: </strong>The establishment of a new unit provides an opportunity to reflect on the complexity of building workforce, service and clinical capacity within the constraints of public health services. The challenges along the way have helped to build empathy for the experiences of the admitted parents who equally find that things have not gone how they have planned, while finding emerging opportunities for growth, resilience and change.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"17-22"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740985","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}