Category Archives: Maternal and Infant Health

Nov 18 2014
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Public Health News Roundup: November 18

Financial Incentives Double Smoking Quit Rates
Offering small financial incentives doubles smoking cessation rates among low-income smokers, according to research from The University of Texas Health Science Center at Houston. The study was published in the American Journal of Public Health. Participants in the intervention group could earn up to $150 in gift cards over four weeks. Progress was monitored for 12 weeks following the quit date. A control group received only cessation information, no incentives. The researchers found that quit rates were 49 percent for those in the incentive group but only 25 percent in the control group. Read more on tobacco.

Two Thirds of Parents Would Take Kids out of Daycare if Other Children Don’t Have Their Immunizations
A national survey of parents with children ages 0-5 found that three quarters of them would take their children out of daycare if at least one quarter of the children at daycare were not up to date on their vaccines. The researchers say the scenario is realistic since about 25 percent of preschool children in the United States are not fully vaccinated, according to national statistics. Just over 40 percent of survey responders also said that children missing vaccines should be asked to leave daycare until they are up to date. Read more on vaccines.

Three Drugs During Pregnancy Better Than Current Complicated Regimen for Preventing Mother-to-Baby HIV Transmission
For HIV-infected women in good immune health, taking a three-drug regimen during pregnancy prevents mother-to-child HIV transmission more effectively than taking one drug during pregnancy, another during labor and two more after giving birth, according to a new study funded by the National Institutes of Health. Read more on maternal and infant health.

Nov 12 2014
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U.S. Preterm Birth Rate Still Too High: Q&A with Jennifer L. Howse, PhD, the March of Dimes

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Last week the March of Dimes releases its annual Premature Birth report card and gave a “C” grade to the United States. While the U.S. rate has seen improvement in recent years and rates of premature birth—which can cause death and lifelong disability—have dropped, the organization says there is still much room for improvement. With World Prematurity Day next week, NewPublicHealth recently spoke with Jennifer L. Howse, PhD, president of the March of Dimes, about the new report card and new efforts by the organization to study premature birth and vastly reduce the U.S. rates further.

NewPublicHealth: What’s most significant about the 2014 report card?

Jennifer Howse: The 2014 report card on premature birth in the United States shows continued improvement. In fact, rates of pre-term birth in the United States have improved. That is they’ve lowered every year for the last seven years and that means that the United States currently has a pre-term birth rate of 11.4 percent, and that rate of pre-term birth is the lowest that it’s been in the in the last 17 years. So we’re very pleased. Having said that, the United States is still short of the target set by the March of Dimes of 9.6 percent or less. Our state-by-state report card assigns a letter grade to the U.S. composite and then to each state up against that goal of 9.6 percent. So, the United States has a “C” overall, but we continue to see progress and improvements—incremental, but progress in far and away the majority of states. So it’s very important around this critical child health issue to set a target, measure the target, and to hold states and the nation accountable.

NPH: What are the things that March of Dimes is doing, has done and will continue to do that are helping that rate?

Howse: The March of Dimes has mobilized a very strong group of partners in this campaign to end premature birth. We have assembled very strong partnerships with clinicians, with state health officials, with hospital leadership, with governmental leaders—particularly in the area of Medicaid programs—and those partnerships have been activated and expanded over the last decade. Specifically, the March of Dimes has led the charge on a quality improvement program across the nation to reduce and eliminate elective induction and C-section before 39 weeks of completed gestation. That’s the QI 39 program, and now two-thirds of hospitals are showing positive results in that arena. 

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Nov 6 2014
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Public Health News Roundup: November 6

EBOLA UPDATE: Administration Asks Congress for $6.18 Billion in Emergency Funds
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The Obama administration has asked the U.S. Congress to approve $6.18 billion in new emergency funds to combat the ongoing Ebola outbreak in West Africa. More than 5,000 people have died so far from the outbreak. The new funds would include:

  • $1.83 billion for the U.S. Centers for Disease Control and Prevention to prevent, detect and respond to the Ebola epidemic and other diseases and public health emergencies abroad and in the United States.
  • $1.98 billion for the U.S. Agency for International Development for foreign assistance in the Ebola crisis.
  • $127 million would go to the U.S. Department of State to expand its medical support and evacuation capacity.
  • $112 million for the U.S. Department of Defense including funding to support efforts to develop technologies relevant to the Ebola crisis.
  • $1.54 billion for a contingency fund, divided between the U.S. Department of Health and Human Services, USAID and State to ensure resources are available to adapt as the crisis evolves.

Read more on Ebola.

CDC: 8 Million Women Ages 21-65 Haven’t Been Screened for Cervical Cancer
Approximately eight million women ages 21-65 years have not been screened for cervical cancer in the past five years, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). More than half of the women who receive a diagnosis of cervical cancer have never been or are rarely screened. “Every visit to a provider can be an opportunity to prevent cervical cancer by making sure women are referred for screening appropriately,” said CDC Principal Deputy Director Ileana Arias, PhD, in a release. “We must increase our efforts to make sure that all women understand the importance of getting screened for cervical cancer. No woman should die from cervical cancer.” Read more on prevention.

U.S. Premature Birth Rate to 11.4 Percent; March of Dimes Gives the Country a ‘C’
The national preterm birth rate has fallen to the Health People 2020 goal of 11.4 percent seven years early. Despite this, the 7th annual March of Dimes Premature Birth Report Card gave the U.S. health care system a “C” for not reaching the organization’s lower target of 9.6 percent. More than 450,000 U.S. babies were born premature in 2013, which leads to increased risks to their health as well as billions of dollars in health care costs. "Achieving the Healthy People 2020 goal is reason for celebration, but the U.S. still has one of the highest rates of preterm birth of any high resource country and we must change that," said March of Dimes President Jennifer L. Howse, MD, in a release. "We are investing in a network of five prematurity research centers to find solutions to this still too-common, costly, and serious problem." Read more on maternal and infant health.

Nov 4 2014
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Public Health News Roundup: November 4

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WHO: Wider Use of Naloxone Could Prevent 20,000 U.S. Drug Overdose Deaths Each Year
More than 20,000 U.S. deaths from drug overdoses could be prevented each year if naloxone were more widely available, according to the World Health Organization (WHO). Approximately 69,000 people around the world die each year from overdoses of heroin or other opioids. Opioids are commonly prescribed for chronic non-cancer pain and are the most addictive substances in common use. Naloxone can be used to counter opioid overdoses. "If opioids are easily available in people's bathroom cabinets, it might make sense for naloxone to be equally available," said WHO expert Nicolas Clark. Read more on substance abuse.

Obesity During Pregnancy Linked to Higher Risk of Kidney, Urinary Tract Abnormalities in Infants
Children of women who are obese are more likely to be born with congenital abnormalities of the kidney and urinary tract, according to a new study to be presented at ASN Kidney Week 2014 in Philadelphia, Penn. While such abnormalities are diagnosed in only 1 percent of pregnancies, they account for 20-30 percent of all prenatal abnormalities. Researchers based their findings on linked birth-hospital discharge records from Washington State from 2003 to 2012. "Our findings add to the public health importance of obesity, particularly as a modifiable risk factor," said study author Ian Macumber, MD. "The data supplement the literature regarding obesity's association with congenital abnormalities and highlight the importance of future research needed to clarify the mechanisms of these associations." Read more on maternal and infant health.

Study: Increased in Autism Cases Due to Changes in How the Condition is Defined
The dramatic increasing in the number of autism cases among children since the mid-1990s is in larger part due to how the condition is reported and defined, with today’s classification system more broader than the one used in the past, according to a new study in JAMA Pediatrics. Danish researchers determined that 60 percent of the increase in cases “can be attributed to changes in diagnostic criteria and the inclusion of out-of-hospital diagnoses.” "That the increase until now has been left more or less unexplained has undoubtedly raised considerable concern among the public and might, in fact, have affected some parents' health decisions regarding their child," said lead researcher Stefan Hansen, from the section for biostatistics in the department of public health at Aarhus University, according to HealthDay. "As our study shows, much of the increase can be attributed to the redefinition of what autism is and which diagnoses are reported. The increase in the observed autism prevalence is not due alone to environmental factors that we have not yet discovered." Read more on pediatrics.

Oct 30 2014
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Public Health News Roundup: October 30

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EBOLA UPDATE: WHO Officials See ‘Glimmers of Hope’ in Liberia as New Case Rate Declines
(NewPublicHealth is monitoring the public health crisis in West Africa.)
There are “glimmers of hope” in Liberia as officials from the World Health Organization (WHO) say the rate of new Ebola cases appears to be declining for the first time since the outbreak began. Still, an official with the global health agency said they are still very much concerned and on guard. “It’s like saying your pet tiger is under control,” said Bruce Aylward, the WHO’s assistant director-general in charge of the operational response, according to The Washington Post. “This is a very, very dangerous disease” and “the danger now is that instead of a steady downward trend we end up with an oscillating trend where the virus goes up and down” because areas become reinfected. Read more on Ebola.

Study: Infant’s Birthweight Tied to Disease Risk Later in Life
An infant’s size at birth may help predict their health later in life, with babies who are heavier have less of a risk for future disease, according to a new study in The FASEB Journal. Researchers based their findings on an analysis of cord blood of newborn babies from mothers with raised glucose levels during late pregnancy and blood taken later. "These findings support the hypothesis that common long-term variation in the activity of genes established in the womb may underpin links between size at birth and risk for adult disease," said Claire R. Quilter, Ph.D., study author from the Mammalian Molecular Genetics Group, Department of Pathology at the University of Cambridge in the United Kingdom. "If confirmed these could be important markers of optimal fetal growth and may be the first step along a path to very early disease prevention in the womb." Read more on maternal and infant health.

FDA Approves New Meningitis Vaccines
The U.S. Food and Drug Administration (FDA) has approved the first vaccine approved to prevent invasive meningococcal disease in the United States. The drug is to prevent  Neisseria meningitidis serogroup B is approved for individuals ages 10 to 25 years. Approximately 500 total cases of meningococcal disease were reported in the United States in 2012, with 160 having been causes by serogroup B. “Recent outbreaks of serogroup B Meningococcal disease on a few college campuses have heightened concerns for this potentially deadly disease,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research, in a release. “The FDA’s approval of Trumenba provides a safe and effective way to help prevent this disease in the United States.” Read more on vaccines.

Oct 20 2014
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Public Health News Roundup: October 20

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EBOLA UPDATE: 43 People Cleared from Ebola Watch Lists in Texas
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Dozens of people in the United States came off of Ebola watch lists this morning after showing no symptoms for 21 days. A total of forty-three people who came into contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, were cleared by Texas’ state health department. Another 120 people are still being monitored. The news comes as lawmakers continue to debate the feasibility and prudence of enacting a travel ban from West Africa. Read more on Ebola.

 

Healthy Lifestyle Habits Could Reduce Gestational Diabetes Cases by Half

Healthy lifestyle habits such as maintaining a normal weight, not smoking and staying physically active may help prevent as many as half of all gestational diabetes cases, according to a new study in the journal BMJ. Researchers analyzed data on more than 14,000 U.S. women, finding that women who were overweight or obese during pregnancy were at four times the risk of developing gestational diabetes. Women with all three of the identified healthy lifestyle behaviors were 83 percent less likely to develop gestational diabetes than were women who lacked all three. Read more on maternal and infant health.

 

Study: Men with IBS Report Greater Interpersonal Difficulties
Men with irritable bowel syndrome (IBS) experience more interpersonal difficulties than do women with the condition, according to a surprising new study presented at the American College of Gastroenterology annual meeting in Philadelphia. IBS symptoms include abdominal pain, diarrhea and/or constipation; it affects an estimate 25 million to 50 million Americans, but is twice as common among women, meaning less is known about how men experience the disorder. The study determined that men report feeling cold and detached, which leads to difficulties in interpersonal relationships. "Our findings underscore the significance of studying gender-based differences in how people experience the same disease or condition," says Jeffrey Lackner, PsyD, professor of medicine in the UB School of Medicine and Biomedical Sciences, in a release. "That discrepancy underscores our need to move beyond clinical intuition and anecdote, and systematically study the different ways that each gender experiences disease in general. Patients who have a domineering and distant interpersonal style may need to work more closely with the physicians.” Read more on health disparities.

 

Oct 10 2014
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Public Health News Roundup: October 10

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EBOLA UPDATE: One-quarter of Americans View Ebola as a ‘Major Threat’ to the United States
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The percentage of Americans who view Ebola as a “major threat” to the United States stands at 27 percent, up from only 13 percent in mid-September, according to a new Harris Poll/HealthDay survey. While saying that the fear is unwarranted, Mayo Clinic infectious diseases physician and researcher Pritish Tosh, MD, said the rising concern is also understandable. "Ebola is an agent that evokes a lot of fear, and can result in societal disruption," said Tosh, according to HealthDay. "There's a reason why it's considered a possible bioterrorism agent. So any time you have any cases in the United States, there is a heightened amount of anxiety." Read more on Ebola.

In-home Parenting Education Improves Mother’s Health, Behavior
In-home, intensive parenting and health education reduces illegal drug use, depression and behavior problems in pregnant American Indian teens, while also improving the likelihood that their children will reach behavioral and emotional milestones, according to a new study in the American Journal of Psychiatry. Researchers at the Johns Hopkins Bloomberg School of Public Health analyzed 322 expectant American Indian teens in four Southwest communities, randomly assigning them to receive optimized care or optimized care plus 63 in-home education sessions, finding that the latter group saw greater improvements in various behaviors. "We found a consistent pattern of success across a number of different outcome measures," says the study's principal investigator John Walkup, MD, an adjunct professor at Johns Hopkins Bloomberg School of Public Health and a faculty member within the Center for American Indian Health. "These early years are critical ones for children. We teach these mothers not only how to be competent parents, but how to cope with stressors and other risk factors that could impede positive parenting skills." Read more on maternal and infant health.

Study: Hospital Patients Don’t Wash their Hands Nearly Enough
Hospital patients aren’t washing their hands nearly enough, according to new research from McMaster University. Researchers analyzed the hand hygiene behavior of 279 adult patients in three multi-organ transplant units of a Canadian acute care teaching hospital over an eight-month period, finding they washed their hands about 30 percent of the time while in the washroom, 40 percent during meals and only 3 percent when using the kitchens in their rooms. "This is important because getting patients to wash their hands more could potentially reduce their risk of picking up infections in the hospital," said principal investigator Jocelyn Srigley, MD, an assistant professor of medicine at McMaster's Michael G. DeGroote School of Medicine, in a release. Read more on prevention.

Oct 2 2014
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Special Delivery: March of Dimes Honors Arizona State Health Director for Work on Improving Turnaround Times on Newborn Screening

An inaugural honor awarded by the March of Dimes last month—the Newborn Screening Quality Award—is the first in a series of awards to state health directors who have made changes to vastly improve newborn screening programs that help prevent death and disability for new babies.

The inaugural award was presented to Will Humble, MPH, director of the Arizona Department of Health Services. He established a policy of full transparency for the length of time it takes Arizona hospitals to send newborn blood samples to the lab for analysis, with a target of having 95 percent of samples screened within 72 hours.

“When hospitals hold onto blood samples for a few days, or a lab is closed on the weekend, this can lead to deadly delays for newborns,” said Edward McCabe, MD, the March of Dimes chief medical officer. “But under Will Humble’s leadership, Arizona has put in place a process that is a model for other states to follow.”

McCabe says the award—named for Robert Guthrie, MD, who developed the first mass screening test for babies in 1963—recognizes leadership in establishing a culture of safety as a way to avoid deadly delays in states’ newborn screening processes.

All states were put on notice about hazardous newborn screening test shipping practices by a Milwaukee Journal Sentinel investigative series, Deadly Delays, published in 2013. She series found that many hospitals delayed sending tests to labs for a variety of reasons, including staff vacations or shortages, or batched the tests in order to save money on shipping, causing diagnosis delays that resulted in babies’ deaths or disabilities.

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Sep 25 2014
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Public Health News Roundup: September 25

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EBOLA UPDATE: Public Health Experts Worried About a ‘New Normal’ For Ebola
(NewPublicHealth is monitoring the public health crisis in West Africa.)
With the World Health Organization announcing that the death toll from the Ebola outbreak in West Africa has now surpassed 2,900 people, public health experts are increasingly resigning themselves to the very real possibility that the outbreak will go on for a very long time. Previous human outbreaks were either stopped quickly or in no more than a few months. However, this outbreak is taking hold in urban areas—previous outbreaks were found in rural areas with smaller, more spread out populations—making it unlike any of the others. “What’s always worked before—contact tracing, isolation and quarantine—is not going to work, and it’s not working now,” said Daniel Lucey, a professor of Microbiology and Immunology at Georgetown University Medical Center, according to The Washington Post. Read more on Ebola.

Common Painkillers Linked to Increased Risk of Blood Clots
Common painkillers including aspirin, naproxen and ibuprofen may be linked to an increased risk of developing dangerous blog clots known as venous thromboembolisms (VTE), according to a new study in the journal Rheumatology. The painkillers are all types of non-steroidal anti-inflammatory drugs (NSAIDs). Researchers analyzed the results of six studies that included 21,401 VTE events, finding that patients who used NSAIDs were almost twice as likely to develop the clots. "Our results show a statistically significant increased VTE risk among NSAIDs users. Why NSAIDs may increase the risk of VTE is unclear,” said study lead author Patompong Ungprasert, in a release. “It is possibly related to COX-2 inhibition leading to thromboxane-prostacyclin imbalance. Physicians should be aware of this association and NSAIDs should be prescribed with caution, especially in patients already at a higher risk of VTE." Read more on heart and vascular health.

U.S. Lags Behind Much of Europe in Infant Mortality Rates
The United States continues to lag behind much of Europe and several other developed nations when it comes to infant mortality rates, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC). Approximately 6.1 U.S. infants died per every 1,000 live births in 2010. While that was down from the rate of 6.87 in 2005, it was still double the rates of Finland, Japan, Portugal, Sweden, the Czech Republic and Norway. "I think we've known for a long time that the U.S. has a higher preterm birth rate, but this higher infant mortality rate for full-term, big babies who should have really good survival prospects is not what we expected," said lead author Marian MacDorman, a senior statistician and researcher in the CDC's National Center for Health Statistics, according to HealthDay. Reasons for the United States’ high rate include prenatal care that leads to the birth of more at-risk preemies, as well as disparities in prenatal care. Read more on maternal and infant health.

Sep 5 2014
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Public Health News Roundup: September 5

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EBOLA UPDATE: Third U.S. Aid Workers Arrives for Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
A third U.S. medical missionary has arrived at the Nebraska Medical Center in Omaha for treatment for Ebola. Rick Sacra, MD, is a SIM USA missionary, as were Kent Brantly, MD, and Nancy Writebol, who were both treated successfully for Ebola at Emory Hospital. Approximately 1,900 people have died and 3,500 have been sickened in the ongoing outbreak. Approximately 400 deaths came in the past week alone. Read more on Ebola.

CDC Report Explores the Extent and Impact of Intimate Partner and Sexual Violence
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report examining the extent and impact of intimate partner and sexual violence. According to the report, almost 20 people per minute are victims of physical violence by an intimate partner; almost 2 million women are raped each year; and more than 7 million women and men are victims of stalking each year. The report determined that since a “substantial portion” of this violence and stalking comes at a young age, primary prevention must also focus on people at young ages, accounting for the differences in victims, addressing risk factors and emphasizing health relationships. Read more on violence.

Study Links Breastfeeding, Lower Weight for Mothers
Mothers who were obese before pregnancy and who then go on to breastfeed may have an easier time losing their pregnancy weight and then keeping it off, according to a new study in journal Pediatrics. Researchers determined that previously obese mothers who breastfed weighed almost 18 pounds less than those who didn’t. "Breast-feeding not only burns extra calories but it also changes the metabolism through a series of hormonal effects required to lactate," said Lori Feldman-Winter, MD, a pediatrician and a professor of pediatrics at Children's Regional Hospital at Cooper University Health Care in Camden, N.J. "The full understanding of how breast-feeding leads to improvements in metabolism for both mother and her baby is incomplete, but there are multiple epidemiological studies showing the association." She also said that the healthier eating habits many mothers who breastfeed take up may also contribute to the lower weights. Read more on maternal and infant health.