Objective: To evaluate the effectiveness of different quantities and types of breastfeeding peer counselor (BFPC) support on breastfeeding (BF) outcomes in women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program.
In the FLR, missing visit information at the end of pregnancy results in an underestimation of mothers' prenatal care. Future research is needed to determine the extent of this missing visit information on the national level.
Objectives
To assess the sensitivity of birth certificates to preterm birth history and determine whether omissions are randomly or systemically biased.
Methods
Subjects who experienced a preterm birth followed by a subsequent pregnancy were identified in a regional database. The variable “previous preterm birth” was abstracted from birth certificates of the subsequent pregnancy. Clinical characteristics were compared between subjects who were correctly versus incorrectly coded.
Results
713 subjects were identified, of whom 65.5% were correctly coded in their subsequent pregnancy. Compared to correctly coded patients, patients who were not correctly identified tended to have late and non-recurrent preterm births or deliveries that were secondary to maternal or fetal indications. A recurrence of preterm birth in the subsequent pregnancy was also associated with correct coding.
Conclusions
The overall sensitivity of birth certificates to preterm birth history is suboptimal. Omissions are not random, and are associated with obstetrical characteristics from both the current and prior deliveries. As a consequence, resulting associations may be flawed.
Objectives
Environmental exposures during pregnancy have a lasting impact on
children's health. We combined environmental and maternal risk
factor survey data to inform efforts to protect children's health.
We made recommendations for future use of such data.
Methods
A modified version of the Pregnancy Risk Assessment Monitoring
System(PRAMS) mail survey was conducted based on weighted sampling design
with low-income and non-low income women in Monroe County, NY (1022
respondents). A series of environmental questions were included in the
questionnaire. Data were analyzed using chi-square tests and Poisson
loglinear regression model to identify patterns in environmental health risk
and sociodemographic characteristics.
Results
We identified women who rented their homes, had lower incomes, and
lived in inner city zip codes as “high environmental health
risk” (HEHR). HEHR respondents were more likely to report that a
health care provider talked with them about lead and on average reported
more behaviors to protect their children from lead poisoning.
Conclusions
Combining environmental and perinatal risk factor data could yield
important recommendations for medical practice, health education, and policy
development. However, at present PRAMS gathers only limited and inconsistent
environmental data. We found that existing PRAMS environmental questions are
insufficient. Further work is needed to develop updated and more
comprehensive environmental health survey questions and implement them
consistently across the country.
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