Social disadvantage and its effect on maternal and newborn health

Barfield, Wanda D.

doi:10.1016/j.semperi.2021.151407

Cited by 18 publications

(7 citation statements)

References 44 publications

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“…similarly, macrosomia is also linked to several maternal complications like diabetes with mothers as well as postpartum hemorrhage which adverse outcomes are associated with several medical care medical care costs [25], [26]. This outcome requires further research to establish more speci c causes of having secondary school women likely to deliver macrosomic newborns, yet education beyond primary level, is associated with positive health and newborn health outcomes [27], [28]. Nonetheless, these ndings are consistent with a study by Chung and others [29].…”

Section: Results Of the Multivariate Multinomial Logistic Regression ...mentioning

confidence: 99%

A Cross Section Study for the Predictors Associated With Birth Weight

Nkeeto

Yawe

Matovu

2023

Preprint

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Introduction Birth weight has three possible outcomes that include normal birth weight (NBW) (2500 – 3999grams), low birth weight (less than 2500 grams), and macrosomia (at least 4000 grams and beyond). Low birth weight (LBW) and macrosomia are considered adverse outcomes of newborn health. The prevalence of LBW globally ranges from 7 – 17 %, whereas, that of macrosomia ranges from 4 – 16%. However, the information established in Uganda during the five years preceding the 2016 Uganda Demographic Health Survey (UDHS), only 67% of mothers had their weights taken at birth, indicating a 33% shortfall. Methods A cross-sectional research design was used on the basis of the dataset of the most recent UDHS of 2016. A sample of 4687 singleton births for which full information of birth weight was attained was used. The multinomial logistic regression model was fitted at both bivariate and multivariate levels with consideration for LBW, NBW, and macrosomia for which NBW was used as the base category. STATA 16 was used for data analysis. Results The results showed that premature birth delivery increases the risk of LBW (RRR 3.5, CI (2.029,5.886)); facility delivery reduces LBW (RRR0.58, CI (0.401, 0.850)). Adequate ANC attendance reduces the risk of LBW (RRR0.38, CI (0.182, 0.794)) and also reduces the risk of macrosomia (RRR0.6, CI (0.340, 1.052)). A male fetus increases the risk of macrosomia comparison category (RRR1.3, CI (1.223, 1.498)), primary education attainment reduces the relative risk of macrosomia (RRR0.8, CI (0.664,0.963)), secondary education increases the relative risk of macrosomia (RRR1.29, CI (1.022,1.634). Conclusion We recommend ANC attendance and facility delivery, given their positive effect on normal birth weight. ANC will guide the feeding habits of expectant mothers as well as ensure nutritional interventions, maternal and fetal assessment for detection of danger and establish the risky gender, implement any preventive measures, intervene in case of common physiological symptoms, and recommend the health system interventions to improve utilization of the available facilities.

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Section: Results Of the Multivariate Multinomial Logistic Regression ...mentioning

confidence: 99%

A Cross Section Study for the Predictors Associated With Birth Weight

Nkeeto

Yawe

Matovu

2023

Preprint

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“…Additionally, recent publications have shown a significant variation in quality of care for mothers and newborns of racial and ethnic backgrounds other than White. 38 Whether the DCC differences are due to disparities in health care or due to increased pregnancy-related comorbidities in minority populations 39 40 that may lead to high-risk deliveries, resulting in less DCC is beyond the scope of this study. However, awareness of these discrepancies and performing DCC for all eligible neonates is a simple and impactful measure in reducing iron deficiency in minority children.…”

Section: Discussionmentioning

confidence: 99%

A Questionnaire Assessing Utilization of Delayed Cord Clamping

Uduwana

Nemerofsky

2021

Am J Perinatol

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Objective The study aimed to assess the practice of delayed cord clamping (DCC) and the awareness of its benefits for newborns between Obstetric (OB) and neonatal physicians. We examined if provider characteristics including years of experience, level of training, familiarity of the American College of Obstetricians and Gynecologists (ACOG)/American Academy of Pediatrics (AAP) recommendations, institutional policy, and the racial and ethnic background of patient population were associated with implementation of DCC. Study Design This research is a cross-sectional online questionnaire study. Results 975 questionnaires were returned. Overall, the awareness of ACOG versus AAP recommendations was 94 versus 86% (p < 0.01). 86 versus 78% of OB and neonatal physicians practiced or witnessed DCC >50% of the time, respectively (p < 0.01). An equal number of OB and neonatal physicians believed in the benefits to newborns of DCC. Physicians with >10 years of practice were less likely to acknowledge DCC benefits. Physicians with a majority of non-White patients were less likely to practice/witness DCC (p < 0.05). Conclusion There continues to be room for improvement in the practice of DCC. Institutional policies and awareness of ACOG/AAP recommendations impact the understanding of the benefits of DCC and the likelihood of the practice. There is a significant difference in the practice of DCC among patients with different racial backgrounds. Hospital leadership may consider investing in the education and implementation of updated guidelines to ensure DCC is routinely practiced. Key Points

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“…Social disadvantage and healthcare inequities disproportionately affect minorities [29]. Identifying and addressing such inequities is imperative.…”

Section: Discussionmentioning

confidence: 99%

Early Discharge from a Newborn Nursery in the United States during the COVID-19 Pandemic

Wood

Schmitz

Bhoojhawon

2022

COVID

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The COVID-19 pandemic changed birth hospitalization, with many hospitals implementing restrictions. Little is known about the impact of the COVID-19 pandemic on rates of early newborn discharge and length of stay (LOS). The primary objective was to compare rates of early discharge before and after the start of the COVID-19 pandemic. Secondary objectives included 28-day readmissions and LOS. A single-center retrospective cohort study was undertaken of all live newborns discharged from a well newborn nursery in the United States between 1 July 2015 and 18 June 2021. The pre-COVID-19 era was defined as 1 July 2015 to 29 February 2020, and the COVID-19 era as 1 March 2020 to 18 June 2021, based on the first case reported in our state. Early discharge was defined as less than or equal to 24 h. A total of 10,589 newborns were included: 8094 before and 2495 after the COVID-19 pandemic started. Overall, 43 newborns (0.41%) were discharged early. In the COVID-19 era, early discharges significantly increased from 0.23% (n = 19) to 0.96% (n = 24) (p < 0.001). Median LOS declined from 52.0 (IQR, 43.0–64.0) to 45.0 (IQR, 37.0–56.0) hours (p < 0.001). The 28-day readmission rate decreased from 2.3% (n = 182) to 1.3% (n = 33) (p < 0.01). Since the start of the COVID-19 pandemic, the number of early discharges has significantly increased at our institution without an increase in readmissions. Additionally, overall decrease in length of stay for the birth hospitalization was observed. Potential reasons include changes in hospital unit policies including visitor limitations to reduce COVID-19 infection risk to patients and staff and/or parental concern for iatrogenic acquisition of the virus.

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Social disadvantage and its effect on maternal and newborn health

Cited by 18 publications

References 44 publications

A Cross Section Study for the Predictors Associated With Birth Weight

A Cross Section Study for the Predictors Associated With Birth Weight

A Questionnaire Assessing Utilization of Delayed Cord Clamping

Early Discharge from a Newborn Nursery in the United States during the COVID-19 Pandemic

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