Maternal and Child Health Journal最新文献

{"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":"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":"591-598"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097947/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal Cannabis Exposure and Neonatal Outcomes: A Systematic Review and Meta-Analysis.","authors":"Anna Bailey, Whitney Kerr, Zahra Alhay, Morgan Rom, Sheryl Hamilton, Janis Campbell, Katrin Kuhn, David Thompson, Jessica A Reese","doi":"10.1007/s10995-025-04096-5","DOIUrl":"10.1007/s10995-025-04096-5","url":null,"abstract":"<p><strong>Introduction: </strong>Current literature addressing fetal cannabis exposure and neonatal outcomes is based on subjective measures with varying levels of significance. This systematic review and meta-analysis determined if neonates with fetal cannabis exposure have an increased odds of being born small for gestational age, low birth weight, admitted to the Neonatal Intensive Care Unit (NICU) immediately after delivery, and/or preterm.</p><p><strong>Methods: </strong>To identify relevant articles, we searched five databases using standard search criteria. Two authors used the Newcastle-Ottawa Scale to exclude articles with a high risk of bias. To estimate the combined effect, we calculated pooled odd ratios (OR) with 95% confidence intervals (CI) using the Mantel-Haenszel method for dichotomous data.</p><p><strong>Results: </strong>Of 3,390 original articles we identified through the search strategy, 13 met the inclusion criteria. This meta-analysis indicates that neonates with fetal cannabis exposure have higher odds of being small for gestational age (OR = 1.79; 95% CI = 1.24-2.59) and/or having a low birth weight (OR = 1.38; 95% CI = 1.05-1.89) compared to neonates without fetal cannabis exposure. The results regarding NICU admission and preterm birth were statistically inconclusive (NICU admission: OR = 1.38, 95% CI = 0.86-2.22; Preterm birth: OR = 1.29, 95% CI = 0.97-1.71). Although the odds ratios for these associations span one suggesting a null relationship, they have an upper bound that may be clinically relevant.</p><p><strong>Discussion: </strong>Based on these findings, further research, as well as an evaluation of the current public health response, is warranted. Additional research is needed to identify the association between neonatal outcomes and specific nuances of fetal cannabis exposure, such as route of ingestion, frequency of use, dose consumed, and the timing of intrauterine exposure.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"703-713"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045923","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":"Factors that Contribute to Neonatal Mortality at a Community Hospital.","authors":"Chrystal Pristell, Alison Huffstetler, Serenity Budd, Fernando Mena","doi":"10.1007/s10995-025-04094-7","DOIUrl":"10.1007/s10995-025-04094-7","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of intrauterine fetal demise (IUFD) in the United States is 5.74 per 1000 live births. In Maryland, the prevalence is 6.75 per 1000 and occurs nearly twice as frequently in Black than in white populations. At MedStar Franklin Square Medical Center (MFSMC), Electronic Medical Records (EMR) show that IUFDs are 2.5 times greater in Black than white women. This analysis aims to identify factors that contribute to this health disparity.</p><p><strong>Methods: </strong>We performed a retrospective chart review of deliveries at MFSMC between 2018 and 2020. Literature-supported variables were collected for all pregnancies that ended in IUFD. Using logistic regression models, these factors were analyzed to isolate predictors for IUFD and association with race. The same predictors were compared to those of women who delivered live infants during this period.</p><p><strong>Results: </strong>Without adjustment, the odds of having an IUFD are 2.21 times higher for Black mothers than for white mothers at MFSMC. No other unadjusted odds ratios between comorbid risk factors and the chance of IUFD were significant. After adjusting for diabetes, growth restriction, substance abuse, and hypertension, the odds of having an IUFD are 2.31 times higher for Black than white mothers.</p><p><strong>Conclusions: </strong>Black mothers experience increased risk for IUFD, after controlling for other pertinent factors. This disparity should be addressed by reducing healthcare provider bias, increasing maternal health services, and providing comprehensive patient education.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"696-702"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054638","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: Evaluation of Prescription Practices for Antenatal Steroids in Pregnant.","authors":"Antalya Jano, Caroline Madigan, Paris Ekeke","doi":"10.1007/s10995-025-04088-5","DOIUrl":"10.1007/s10995-025-04088-5","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"621"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722029","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":"Baby-Act Intervention to Prevent Excessive Infant Weight Gain: Development, Implementation, Lessons Learned, and Future Applications.","authors":"Maria G Kallis Colon, Adolfo Lopez, Maribel Campos Rivera, Jeremy Pomeroy, Cristina Palacios","doi":"10.1007/s10995-025-04082-x","DOIUrl":"10.1007/s10995-025-04082-x","url":null,"abstract":"<p><strong>Objectives: </strong>There are limited interventions for preventing excessive infant weight gain among Hispanic and low-income populations. Here, we describe the development/implementation of the Baby-Act trial, a multi-component/multi-model intervention for preventing excessive infant weight gain in low-income Hispanics. We also report adherence/fidelity, lessons learned, and future applications.</p><p><strong>Methods: </strong>We conducted a cluster-randomized controlled trial among mother/infant participants of the WIC program in Puerto Rico. The intervention included responsive feeding, infant activation, healthy sleep, and limiting sedentary behaviors using behavioral change theories. It was implemented as a multi-modal approach from pregnancy to the first year of life through weekly online interactive lessons (n = 56) that focused on one of the topics, reinforced with weekly text messages and monthly calls with a dietitian. Adherence/fidelity was recorded as the number of lessons/calls completed and text messages sent/received in the order designed.</p><p><strong>Results: </strong>Adherence from 207 participants was 45.7% for pregnancy lessons and 31.4% for baby lessons (higher in months 0-3 and for lessons that suggested uploading images/videos). On average, 19 lessons were completed (with 3.6 lessons completed on the same day instead of once per week). Adherence to calls was 42.3% (higher in the first months, 49.0%). On average, each participant completed 5 calls. Lessons/calls/texts were completed/received as designed; 99.3% of text messages were sent.</p><p><strong>Conclusions: </strong>Adherence to all intervention components was low, but all participants received the main messages because the topics were repeated continuously. Future studies should reduce the frequency of lessons, include more text messages, and more sharing of videos/photos.</p><p><strong>Clinicaltrials: </strong>GOV: NCT03517891.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"572-581"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694177","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":"Infants in the Child Welfare System: Exposure and Risks of Parental Alcohol and Drug Misuse.","authors":"Lindsey Palmer, Sarah Font, Julia Reddy, Rebecca Rebbe, Eunhye Ahn","doi":"10.1007/s10995-025-04085-8","DOIUrl":"10.1007/s10995-025-04085-8","url":null,"abstract":"<p><strong>Objective: </strong>To document the prevalence of parental alcohol and drug misuse (PADM) in infants' first and subsequent child welfare cases, and to assess the risk of subsequent injury for infants exposed to PADM.</p><p><strong>Methods: </strong>This study used linked Medicaid and child welfare system (CWS) data in Pennsylvania to identify all children born between 2016 and 2018 who had a confirmed CWS case by age one (N = 20,998). The injury analyses focused on children whose initial case included PADM and who were covered by Medicaid at birth (N = 11,180). Survival analyses and Cox Proportional Hazard models were used to assess risk of any physical harm, severe harm and head injuries among infants who remained in home following PADM exposure.</p><p><strong>Results: </strong>Study documented that 64% of infants' first cases included PADM. Infants with a PADM case who remained at home (versus entered care) were at increased risk of experiencing subsequent physical harm, severe physical harm, and head injuries. Few differences in harm outcomes were observed between infants with and without medically diagnosed prenatal substance exposure.</p><p><strong>Conclusions: </strong>The Child Abuse Prevention and Treatment Act instructs medical professionals to create 'plans of safe care' for infants affected by substances, however, limitations in PADM identification as well as an insufficient public health response has resulted in many families not receiving the support and services needed. Coordinated efforts are needed to prevent, detect, and treat substance use disorders.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"582-590"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732458","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 Enduring Mission of the MCH Journal: Affirming the Right To Science, Practice, and Community in Maternal and Child Health.","authors":"Donna Petersen, Timothy Dye, Milton Kotelchuck","doi":"10.1007/s10995-025-04089-4","DOIUrl":"10.1007/s10995-025-04089-4","url":null,"abstract":"","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"439-440"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755207","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":"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}