Category Archives: Maternal and Infant Health
Study: Families With Preschoolers Purchasing Fewer High-Calorie Drinks
Recent progress in stalling and perhaps even reversing the childhood obesity epidemic may be linked to fewer families with preschool-aged children purchasing high-calorie drinks, according to a new study in the American Journal of Preventive Medicine. Researchers used Nielsen Homescan data from approximately 43,000 U.S. households with young children from 2000 to 2011, identifying the top 20 foods and beverages purchased. “Decreases in purchases of fluid milks, soft drinks, juice and juice drinks, and grain-based desserts were the primary drivers of this change,” said lead author Christopher Ford, MPH, doctoral candidate in nutrition at the University of North Carolina’s Gillings School of Global Public Health. “These data suggest that these households may have purchased fewer calories from solid fats and added sugars.” Previous research shows that approximately 70 to 80 percent of a preschooler’s diet comes from food purchased at stores. Read more on nutrition.
Peace Corps Withdraws from Three West African Countries Due to Ebola Crisis
The Peace Corps announced yesterday that it was removing all 340 of its volunteers from Liberia, Sierra Leone and Guinea in reaction to the increasing spread of the Ebola virus in West Africa. The organization said it has been working closely with experts from the U.S. Centers for Disease Control and Prevention and the U.S. Department of State to monitor the health crisis and determine how it should respond. “The Peace Corps has enjoyed long partnerships with the government and people of Liberia, Sierra Leone and Guinea and is committed to continuing volunteers’ work there,” according to a Peace Corps release. “A determination on when volunteers can return will be made at a later date.” Read more on global health.
Study: Women Who Live Near Green Spaces Give Birth to Healthier Babies
Pregnant women who live near green spaces—such as parks, community gardens and even cemeteries—give birth to healthier babies with significantly higher birth weights, according to a new study in the journal Occupational and Environmental Medicine. Researchers analyzed data on approximately 40,000 single live births in Tel Aviv, Israel. "We found that overall, an increase of surrounding greenery near the home was associated with a significant increase of birth weight and decreased risk for low birth weight," said Michael Friger, PhD, of Ben-Gurion University of the Negev's Department of Public Health. "This was the first study outside of the United States and Europe demonstrating associations between greenery and birth weight, as well as the first to report the association with low birth weight." Read more on maternal and infant health.
NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to firstname.lastname@example.org.
The March of Dimes has launched a PSA “selfie” campaign to remind women that if a pregnancy is healthy then it’s best to aim for at least 39 completed weeks of gestation before scheduling a delivery. The campaign features photos of women well into their pregnancies—bellies out to there and all with broad smiles.
According to the March of Dimes, important development of the brain, lungs and other organs occurs during the last weeks of pregnancy. The organization, along with state and local health departments, has increased its attention on the issue in the last few years.
“Every week of pregnancy is crucial to a newborn’s health,” said March of Dimes President Jennifer L. Howse, MD. “We believe that using ‘selfie’ photos will help reach today’s mothers-to-be, so they understand that healthy babies are worth the wait.”
The campaign photos all come (with permission) from women who have downloaded a free March of Dimes app, Cinemama, which lets expecting moms take and store selfies to give them a photo record of their pregnancies. Television stations across the country are giving free air time to broadcast the PSA.
>>Bonus Link: Read more on NewPublicHealth about maternal and infant health.
HHS, DOJ Release ‘Roadmap’ to Prevent Elder Abuse
The U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) have announced a new Elder Justice Roadmap to enhance elder abuse prevention and prosecution, while also highlighting the issue of elder abuse. An estimated one in 10 Americans over the age of 60 have experienced elder abuse or neglect. The Roadmap includes the DOJ’s development of an interactive, online curriculum to teach legal aid and other civil attorneys to identify and respond to elder abuse, as well as the HHS’ development of a voluntary national adult protective services data system. “Elder abuse is a problem that has gone on too long, but the Roadmap Report released today can change this trajectory by offering comprehensive and concrete action items for all of the stakeholders dedicated to combating the multi-faceted dimensions of elder abuse and financial exploitation,” said Associate Attorney General Tony West, in a release. “While we have taken some important steps in the right direction, we must do more to prevent elder abuse from occurring in the first place and face it head on when it occurs.” Read more on aging.
Study: Health Care Providers Must Do More to Ensure Pregnant Women Receive the Flu Vaccine
A new study finds that health care providers (HCPs) must do more to ensure pregnant women are vaccinated against influenza. After a review of 45 research papers, researchers determined that HCP influenza vaccine recommendations and on-site services would both help increase the current suboptimal vaccination rate. The study pointed to inadequate knowledge of the risks of influenza; doubts about vaccine safety, efficacy and benefits; and fear of adverse reactions for both the pregnant women and their unborn fetuses as barriers to vaccination. Many of the women in the review were also unaware that their pregnancies placed them at higher risk of complications from influenza. Read more on maternal and infant health.
Study: Younger Pro Pitchers at Higher Risk of Needing ‘Tommy John’ Surgery
Stephen Strasburg. Matt Harvey. Kerry Wood. All were or are hard-throwing Major League Baseball (MLB) pitchers who underwent “Tommy John” surgery early in their careers. Now, a new study from researchers at the American Orthopaedic Society for Sports Medicine indicates that entering the MLB at a younger age increases the risk of needing Tommy John surgery—which is a reconstruction of the ulnar collateral ligament in the elbow—at some point in a career. In a study of 168 pitchers who had Tommy John surgery and 178 age-matched pitchers who did not, approximately 60 percent of those who needed the surgery had it in the first five years of their career. They also had statistically more Major League experience, indicating that arm stress at a younger age heightens the risk of damage. “Having athletic trainers and team physicians closely look at when players’ pitching performance stats start to decrease may allow for steps to be taken before a surgery is needed. Our study also further highlights the need for kids not to overuse their arms early in their pitching careers,” said lead author Robert Keller, MD, of Henry Ford Hospital in Detroit, in a release. Read more on injury prevention.
Study: Indoor Cooking Can Lead to Exposure to Dangerous Pollutants
Routine cooking also routinely exposes many Americans to dangerously high levels of pollutants such as carbon monoxide (CO), nitrogen dioxide (NO2) and particulate matter (PM), according to a new study in the journal Environmental Health Perspectives. While the World Health Organization is currently establishing guidelines for indoor air quality, neither the U.S. Environmental Protection Agency (EPA) nor any other U.S. agency regulate indoor air quality in non-industrial buildings. Researchers determined that during the average winter week approximately 1.7 million Californians could be exposed to excessively high CO levels simply because of cooking on gas stoves without range hoods; 12 million could be exposed to excessive NO2 levels. “That’s a lot of people in California, and those results ballpark-apply across the country,” said Brett Singer, study author and a staff scientist at Lawrence Berkeley National Laboratory (LBNL). “The EPA would say we don’t have a carbon monoxide or nitrogen dioxide problem in this country...In reality, we absolutely do have that problem; it’s just happening indoors.” The researchers listed improved ventilation; improved filtration; and improved building codes and standards as ways to combat the public health danger. Read more on air and water quality.
Multiple Errors Behind CDC’s Anthrax Exposure Incident
Multiple protocol breaches at a U.S. Centers for Disease Control and Prevention (CDC) laboratory led to 84 workers being exposed to live anthrax, including the fact that CDC researchers allowed only 24 hours to kill the pathogens—half the recommended time—according to Reuters. So far no one has died or become ill from the unprecedented U.S. exposure incident, but they are being treated with a vaccine and antibiotics. The errors at the biosafety level 3 facility raise new concerns over lax laboratory oversight. "If the protocol was already there, then there is really no excuse for it," said Amesh Adalja, MD, an infectious disease expert at the University of Pittsburgh Medical Center. "The question goes down to personnel and why wasn't protocol followed.” Read more on infectious disease.
Study: Autism Risk Higher in Children Whose Mothers Lived Near Commercial Pesticides
Pregnant women who live within a mile of places where commercial pesticides area used—including farms, golf courses and other public places—are more likely to have children with an autism spectrum disorder, according to a new study in the journal Environmental Health Perspectives. In a study of approximately 1,000 families, researchers determined that depending on the kinds of chemicals used, proximity to the treated area and when during the pregnancy the mother was exposed, their children were 60 to 200 percent more likely to develop autism; exposure during the third trimester brought the highest risk. Approximately one in every 68 children has autism, according to the U.S. Centers for Disease Control and Prevention. Read more on maternal and infant health.
CDC: Induced Births Down for the First Time in Two Decades
The rate for the induction of labor for single births is down for the first time in two decades, according to data from the U.S. Centers for Disease Control and Prevention. While the decrease is small—down to 23.3 percent in 2012 from 23.7 percent in 2011—it is also positive, as induced labor can increase the risk of cesarean section, neonatal infections and neonatal respiratory complications. Induction rates at 38 weeks were also lower for 36 states and the District of Columbia, ranging from a low of 5 percent to as high as 48 percent. Induced labor for non-medical reasons is not recommended before 39 weeks of gestation. Read more on maternal and infant health.
Study: Antidepressant Warnings Linked to Rise in Teen Suicide Attempts
An effort to improve public safety by warning patients about the potential dangers of antidepressants may have had the unintended consequence of actually increasing teen suicide attempts, according to a new study in the journal BMJ. Researchers determined that antidepressant prescriptions for young people dropped approximately 20 percent after the U.S. Food and Drug Administration’s (FDA) 2003 warning mandate. At the same time, teen suicide attempts climbed nearly 22 percent, with researchers pointing to untreated depression as a likely explanation. "To a certain extent, the FDA's black box warning was legitimate, but the media emphasis was really on suicide without noting the potential risk of undertreatment of depression,” said lead author Christine Lu, an instructor in population medicine at the Harvard Pilgrim Health Care Institute in Boston, according to HealthDay. “Because of that, there has been an overreaction, and that overreaction has sent alarming messages to parents and young people.” Read more on mental health.
FDA: Voluntary Recall of Generic High Blood Pressure Medication
India's Dr Reddy's Laboratories Ltd. has begun a voluntary recall of 13,560 bottles of a high blood pressure drug in the United States. The U.S. Food and Drug Administration (FDA) announced that the metoprolol succinate—which is a generic form of AstraZeneca Plc's Toprol XL—failed a dissolution test, which calculates how long it takes a drug’s active ingredient to be released into the body. The recall began on May 23. In March, Dr Reddy's recalled nearly 60,000 bottles of a heartburn drug because of microbial contamination. Read more on prescription drugs.
FDA: Pregnant Women Should Eat More Fish Lower in Mercury
Pregnant women should be eating more fish that is lower in mercury, according to new draft advice from the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA). According to the FDA, pregnant women should eat 8-12 ounces (2-3 servings) per week of fish that are lower in mercury to support fetal growth and development. “For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, MD, the FDA’s acting chief scientist. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.” The draft advice also includes new guidelines for breastfeeding women, those who might become pregnant and young children. Read more on maternal and infant health.
Study: Direct, Indirect Costs of Autism are Substantial
It costs an average of $2.4 million to support a person with an autism spectrum disorder (ASD) and an intellectual disability throughout the course of their life in the United States and $1.4 million to support someone with an ASD but without an intellectual disability, according to a new study in the journal JAMA Pediatrics. With children, the largest contributors to that total are special education services and parental productivity loss. For adults, the largest contributors are residential care or supportive living accommodation and individual productivity loss; adult medical costs are also much higher. According to the researchers, these substantial direct and indirect economic effects illustrate the need to develop more effective interventions to alleviate the strain on families. Read more on pediatrics.
CDC: 29M People in the U.S. have Diabetes—and One in Four Don’t Realize It
More than 29 million people in the United States have diabetes—and one in four don’t even realize it, according to the U.S. Centers for Disease Control and Prevention (CDC). The total estimate is up from 26 million in 2010. According to the CDC, one in three U.S. adults (86 million) have prediabetes, meaning their sugar levels are high, but not high enough to be classified as type 2 diabetes; an estimated 15-30 percent of these people will develop type 2 diabetes within 5 years unless they lose weight and increase their physical activity. “These new numbers are alarming and underscore the need for an increased focus on reducing the burden of diabetes in our country,” said Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “Diabetes is costly in both human and economic terms. It’s urgent that we take swift action to effectively treat and prevent this serious disease.” Read more on diabetes.
Overly Clean Homes Can Increase Child’s Risk of Asthma, Allergies
Living in an overly clean home can actually increase an infant’s risk of developing allergies or asthma as they grow older, as their bodies are not given the chance to develop appropriate responses, according to a new study in the Journal of Allergy and Clinical Immunology. The researchers behind the study were surprised by the results, as they had been looking deeper into data that found that exposure to roach, mouse and pet droppings and other allergens increased asthma risk. "What we found was somewhat surprising and somewhat contradictory to our original predictions," said study co-author Robert Wood, MD, chief of the Division of Allergy and Immunology at the Johns Hopkins Children's Center in Baltimore, according to HealthDay. "It turned out to be completely opposite—the more of those three allergens you were exposed to, the less likely you were to go on to have wheezing or allergy." Approximately 40 percent of the allergy- and wheeze-free children in the study were raised in homes with high amounts of allergens and bacteria, while only 8 percent who suffered from both conditions had been exposed to allergens and bacteria while infants. Read more on pediatrics.
Study: Prenatal Medicaid Policy Reduces Smoking, But Doesn’t Improve Preterm Birthweights
While a Medicaid policy that fast-tracks applications of pregnant women helps reduce smoking during pregnancy, it has no significant effect on improving preterm birth rates or low birth weights, according to a new study in the journal Health Affairs. The study specifically looked at Medicaid’s presumptive eligibility and unborn-child option, which provides coverage for prenatal care. “Although the prevalence of prenatal smoking in the United States has declined in recent decades, it is nearly twice as high among low-income women enrolled in Medicaid than it is in the U.S. population as a whole,” said Marian Jarlenski, PhD, lead author of the paper. “Our research shows that Medicaid’s presumptive eligibility policy led to a nearly 8 percentage-point decrease in smoking during pregnancy, but neither policy significantly improved rates of preterm birth or babies born small for their gestational age.” Read more on maternal and infant health.
CDC: Watercress Tops ‘Powerhouse’ Fruits and Vegetables List
With a “nutrient density score” or 100.00, watercress tops the U.S. Centers for Disease Control and Prevention’s (CDC) new list of “powerhouse” fruits and vegetables. The list of 41 foods was created as a tool for nutrition education and dietary guidance. The study defined “powerhouse” as foods most strongly associated with reduced chronic disease risk, which are often green leafy, yellow/orange, citrus and cruciferous items. Chinese cabbage, chard, beet green and spinach rounded out the top five. The full list is available here. Read more on nutrition.
FDA Initiative Gives Developers Easy Access to Public Health Data
A new online initiative from the U.S. Food and Drug Administration (FDA), openFDA, will give mobile application creators, web developers, data visualization artists and researchers access to the agency’s vast public health datasets in order to streamline the creation of their own applications. The structured, computer-readable format allows researchers to determine what types of data they want to search and how they want to present that data to end-users. “The openFDA initiative leverages new technologies and methods to unlock the tremendous public data and resources available from the FDA in a user-friendly way,” said Walter S. Harris, the FDA’s chief operating officer and acting chief information officer. “OpenFDA is a valuable resource that will help those in the private and public sectors use FDA public data to spur innovation, advance academic research, educate the public, and protect public health.” Read more on technology.
Study: 24 Million U.S. Youth Exposed to E-cigarette Advertisements
Unlike with traditional cigarettes, the U.S. Food and Drug Administration (FDA) does not regulate the marketing of e-cigarettes unless they are advertised as a smoking cessation aid. As a result, e-cigarette companies currently market their products to an audience that includes 24 million youth, according to a new study in the journal Pediatrics. Researchers determined that, from 2011 to 2013, youth exposure to e-cigarette advertisements climbed 256 percent and young adult exposure climbed 321 percent. They also determined that approximately 76 percent of the youth exposure came from advertisements on cable networks. Read more on tobacco.
Study: Global Investment in Midwives Needed to Save the Lives of Mothers, Newborns
Investments in midwifery could save the lives of millions of mothers and newborns, according to a new report from the United Nations Population Fund (UNFPA), the International Confederation of Midwives (ICM) and the World Health Organization (WHO). The report determined that 73 African, Asian and Latin American countries experienced 96 percent of the world’s maternal deaths, 91 percent of stillbirths and 93 percent of newborn deaths, with lack of access to midwives a significant contributing factor. Those countries have only 42 percent of the world’s midwives, nurses and doctors.
- Among the report’s recommendations:
- Increased access to preventive and supportive care from a collaborative midwifery team
- Immediate access to emergency services when needed
- Completing post-secondary education
- And, from a broader perspective, women should delay marriage, have access to healthy nutrition and receive four pre-birth care visits
"Midwives make enormous contributions to the health of mothers and newborns and the well-being of entire communities. Access to quality health care is a basic human right. Greater investment in midwifery is key to making this right a reality for women everywhere," said Babatunde Osotimehin, UNFPA Executive Director, in a release. Read more on maternal and infant health.
Census: Bicycle Commuting Up 60 Percent in Past Decade
U.S. cities across the country are seeing increases in bicycle commuters, according to a recent report from the U.S. Census Bureau. The report found that the total number of people who use a bike to get to work jumped by approximately 60 percent in the past decade, to about 786,000 during the 2008-2012 period, making the largest percentage increase of all commuting modes tracked by the 2000 Census and the 2008-2012 American Community Survey. Portland, Ore. had the highest bicycle-commuting rate at 6.1 percent; the overall national rate was 0.6 percent. "In recent years, many communities have taken steps to support more transportation options, such as bicycling and walking," said Brian McKenzie, a Census Bureau sociologist and the report's author, in a release. "For example, many cities have invested in bike share programs, bike lanes and more pedestrian-friendly streets." Read more on physical activity.
May 19 is ‘Hepatitis Testing Day’
Approximately 5.3 million Americans live with chronic viral hepatitis, although many don’t even realize they’re infected, according to the U.S. Department of Health and Human Services. Today, May 19, marks the third national Hepatitis Testing Day, founded to work to increase the number of people who know their hepatitis B and hepatitis C status; what severe—or even fatal—complications they may face if they’re infected; and their risk of spreading it to others. The U.S. Centers for Disease Control and Prevention (CDC) offers an online Hepatitis Risk Assessment, which utilizes brief questions to determine risk, and then prints out recommendations based on CDC’s testing and vaccination guidelines to discuss with their health care provider. Read more on prevention.
Current, Former Smokers May Have Harder Time Becoming Pregnant
Current and former smokers may face more difficulty when trying to become pregnant, according to a new study in the journal Fertility and Sterility. Researchers at the Boston University School of Public Health (BUSPH) analyzed the chances of getting pregnant among 686 current smokers, 741 former smokers and 2,346 women who never smoked, finding that among the former smokers with the highest level of exposure, the chance of getting pregnant was reduced on average by 26 percent per menstrual cycle. “Pregnant women are already encouraged to quit smoking because of the risks to the mother and baby. Some women might not be aware that current regular smoking also harms female fertility, as concluded by the U.S. Surgeon General based on observational studies and animal studies,” said Rose Radin, a doctoral student in the BUSPH Department of Epidemiology and the lead author of the study, in a release. “Our study also found that current regular smokers take longer to get pregnant than never smokers.” Read more on tobacco.
Future of Public Health is an ongoing series focused on the emerging faces in the world of public health. We spoke with Margo Klar, MPH, a PhD candidate in the Department of Epidemiology at the University of Florida’s College of Public Health & Health Professions, about what helped lead her to the field, her Bill and Melinda Gates Foundation-funded work in maternal health, and where she hopes to go from here.
NewPublicHealth: What encouraged you to pursue a degree and career in public health?
Margo Klar: As an undergraduate at the University of California, Irvine (UCI) I majored in Chemical Engineering and worked in an environmental engineering lab. My undergraduate research focused on the effects of urban runoff on water quality, which we tracked from inland California to the ocean. During my last quarter at UCI, I took a biomedical engineering course. As a part of the class, we were asked to invent a new sleep apnea device. I really enjoyed that creative process and it opened my eyes to the fields of biomedical engineering and medicine.
After graduating, I began looking at applying to medical schools. I went back to school and took anatomy and biology prerequisites. My anatomy teacher once said, “In the United States we worry about problems with our feet, in other countries people don't have feet.” This really resonated with me. While researching medical school programs, I learned about Master of Public Health programs. I decided the MPH would be a great stepping-stone and improve my application to medical school. I was accepted into the Yale School of Public Health in the department of Environmental Health Science. Not only did I receive the training necessary to evaluate health and look for ways to improve global health, I was also able to direct my own thesis research project. I wrote my master’s thesis on an indoor cookstove improvement project for Proyecto Mirador, LLC in rural Honduras. I collected health data and examined indoor air quality improvement and reduction of firewood use as a result of cookstove replacement. This was a terrific learning experience.
NPH: You’ve received a Grand Challenges Explorations grant from the Bill and Melinda Gates Foundation to develop ceramic umbilical cord scissors. What drove you to pursue maternal and child health coming from an environmental background?
Klar: My mentor at Yale, Catherine Weikart Yeckel, PhD thought I should take a look at the Grand Challenges Explorations grant through the Gates Foundation. Essentially this funding mechanism releases a set of topics every six months to which they fund somewhere between 80 to 100 grants to the amount of $100,000 for two years of work. After the first proof of concept phase is complete, a second phase application can be submitted for up to $1 million.
Dr. Yeckel encouraged me to take a look at the maternal and child health topic. Essentially, I Googled top reasons for neonatal mortality in developing countries- neonatal tetanus and infection as a result of poor birthing hygiene and the way the umbilical cord is cut, was among the top causes. I really did not, at the time, have a strong interest in maternal and child health. I had an interest in problem solving, mainly because it’s been something, which has been a personal strength throughout my education. Thanks to my engineering background, I can look at a problem and come up with a solution to try to mitigate it. So, essentially I just applied my problem solving skills to the maternal and child health topic.