Category Archives: Maternal and Infant Health
CDC: U.S. Malaria Cases Reached 40-year High in 2011
U.S. malaria cases reach a 40-year high in 2011, with 1,925 total cases and five associated deaths, according to a supplement of the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR). The 2011 total was a 14 percent increase over the 2010 statistic. According to the CDC, the vast majority of the U.S. cases were acquired overseas, with about 69 percent coming from Africa, and 63 percent of those cases from West Africa. “Malaria isn’t something many doctors see frequently in the United States thanks to successful malaria elimination efforts in the 1940s,” said CDC Director Tom Frieden, MD, MPH. “The increase in malaria cases reminds us that Americans remain vulnerable and must be vigilant against diseases like malaria because our world is so interconnected by travel.” Preventative measures include antimalarial drugs, insect repellent, insecticide-treated bed nets, and protective clothing. Read more on infectious disease.
FDA Proposes New Rules to Combat Prescription Drug Shortages
The U.S. Food and Drug Administration (FDA) yesterday proposed a new plan to combat drug shortages by requiring drug and biotechnology firms to immediately notify the FDA of any potential disruptions in the supply of medically important drugs. These drug shortages can delay or even deny care to patients in critical need. There were 117 drug shortages in 2012, down from 251 in 2011, when the White House issued an executive order to solve the public health problem. The new plan calls for companies to promptly notify the FDA of a permanent discontinuance or a temporary interruption likely to disrupt the supply of a prescription drug. Early notification enables the FDA to work with manufacturers to investigate the reasons for disruptions; identify other manufacturers who can help make up for the shortfall; and expedite inspections and reviews of drugs that could help mitigate a shortage. The FDA also released a strategic plan that “highlights opportunities for drug manufacturers and others to prevent drug shortages by promoting and sustaining quality manufacturing.” “The complex issue of drug shortages continues to be a high priority for the FDA, and early notification is a critical tool that helps mitigate or prevent looming shortages,” said Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research. “The FDA continues to take all steps it can within its authority, but the FDA alone cannot solve shortages. Success depends upon a commitment from all stakeholders.” Read more on prescription drugs.
March of Dimes: U.S. Preterm Birthrate at 15-year Low, But Country Still Gets a ‘C’ Grade
The U.S. preterm birthrate fell to a 15-year low of 11.5 percent in 2012, according to a new report from the March of Dimes. While that’s also a six consecutive year of lower rates, the national still received a “C” on the report card when compared to other countries. "Although we have made great progress in reducing our nation's preterm birth rate from historic highs, the U.S. still has the highest rate of preterm birth of any industrialized country. We must continue to invest in premature birth prevention because every baby deserves a healthy start in life," said Jennifer Howse, MD, president of the March of Dimes. Only six U.S. states received an “A” on the annual report card: Alaska, California, Maine, New Hampshire, Oregon and Vermont. An infant is premature if they are born before 37 weeks of pregnancy; the potential health complications include breathing problems, developmental delays, cerebral palsy and even death. Read more on maternal and infant health.
HHS: $8M in Research Grants to Support Hurricane Sandy Recovery
The U.S. Department of Health and Human Services (HHS) has awarded more than $8 million in research grants to support the long-term recovery of areas of the country damaged by Hurricane Sandy in late 2012. The grants, which are part of the Hurricane Sandy Recovery and Rebuilding Supplemental Appropriation Act of 2013, will go toward research on issues such as community resilience; risk communications and the use of social media; health system response and health care access; evacuation and policy decision making; and mental health. “We hope the grants provide a catalyst for the scientific community to put more emphasis on the study of recovery from disasters; much more research is needed to support decision making in the long-term recovery process and ultimately to improve resilience,” said Nicole Lurie, MD, HHS assistant secretary for preparedness and response. “We anticipate that the findings not only will help community leaders make evidence-based decisions about recovery plans and policies in affected areas but also that the knowledge gained can improve resilience across the entire country.” Read more on disasters.
NIH, CDC Launch National Registry on Sudden Deaths in the Young
The U.S. National Institutes of Health (NIH) and the U.S. Centers of Disease Control and Prevention have come together in the launch of the Sudden Death in the Young Registry. The registry will catalogue conditions such as heart disease and epilepsy in order to help researchers better understand the issues and establish future research priorities. According to the NIH, up until now there have not been agreed upon standards or definitions for reporting these deaths, which has impeded efforts to determine the best prevention efforts. "The sudden death of a child is tragic and the impact on families and society is incalculable," said Jonathan Kaltman, MD, chief of the Heart Development and Structural Diseases Branch within the Division of Cardiovascular Sciences at the NIH's National Heart, Lung, and Blood Institute. "This registry will collect comprehensive, population-based information on sudden unexpected death in youths up to age 24 in the United States. It is a critical first step toward figuring out how to best prevent these tragedies." Read more on research.
Mother’s Smoking During Pregnancy Increases Infant’s Risk of Infections, Death
Mothers who smoked during pregnancy are more likely to have children who are at increased risk for hospitalization and death during infancy, according to a new study in the journal Pediatric Infectious Diseases. The study analyzed hospital records and death certificates of approximately 50,000 Washington state infants born between 1987 and 2004. Researchers say a weakening of the child’s immune system may be responsible for the heightened risk. "We've known for a long time that babies born to mothers who smoke during pregnancy are at high risk for serious medical problems relating to low birth weight, premature delivery and poor lung development," said lead author Abigail Halperin, MD. "While respiratory infections have been recognized as a common cause of these sometimes life-threatening illnesses, this study shows that babies exposed to smoke in utero [in the womb] also have increased risk for hospitalization and death from a much broader range of infections—both respiratory and nonrespiratory—than we knew before.” Read more on tobacco.
Medical Groups Issue New Definitions for Stages of Pregnancy
With a goal toward improving newborn outcomes and reducing non-medically related deliveries, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) are recommending four new definitions of ‘term’ deliveries:
- Early Term: Between 37 weeks 0 days and 38 weeks 6 days
- Full Term: Between 39 weeks 0 days and 40 weeks 6 days
- Late Term: Between 41 weeks 0 days and 41 weeks 6 days
- Post term: Between 42 weeks 0 days and beyond
Research over the past several years finds that every week of gestation matters for the health of newborns, and that babies born between 39 weeks 0 days and 40 weeks 6 days gestation have the best health outcomes, compared with babies born before or after this period. ACOG and SMFM encourage physicians, researchers, and public health officials to adopt these new precisely-defined terms in order to improve data collection and reporting, clinical research, and provide the highest quality pregnancy care. ACOG is a partner with the U.S. Department of Health and Human Services on “Strong Start,” a public awareness campaign to reduce unnecessary elective deliveries before 39 weeks’ gestation. Read more on maternal and infant health.
Poll Shows Americans Strongly Supporting Steps to Reduce Racial and Ethnic Inequality
A new poll conducted by the Center for American Progress and PolicyLink, and funded by The Rockefeller Foundation, finds that Americans are much more open to diversity and supportive of steps to reduce inequalities between racial and ethnic groups than has been previously thought. The poll was conducted by landline and cellphone in June and July among close to 3,000 U.S. citizens across the country. Some key findings of the poll include:
- Positive sentiments about opportunities from rising diversity tend to outweigh negative concerns.
- Sixty-nine percent of responders said that a bigger, more diverse workforce will lead to more economic growth and that diverse workplaces and schools will help make American businesses more innovative and competitive.
- More than 7 in 10 Americans support new steps to reduce racial and ethnic inequality in America through investments in areas such as education, job training and infrastructure improvement. Among Whites, the level of support was 63 percent.
Read more on health disparities.
CDC: Flu Season Slow So Far…But Should Pick Up Soon
While the flu season has seen relatively few cases so far, public health officials expect that to change soon and are heavily recommending that anyone who has yet to be vaccinated go ahead and do so. Joe Bresee, MD, chief of the epidemiology and prevention branch in the U.S. Centers for Disease Control (CDC) and Prevention's Influenza Division, said 135 to 139 million doses of vaccine should be available; the number of people who receive the vaccine annually has risen since 2009. "It's edging up in most groups, which is really gratifying, especially in some of the high-risk groups like pregnant women and kids. We are seeing good gains over the last four or five years," he said. "But we have a long way to go. Still only half of Americans get vaccinated. Vaccine is still the single best thing folks can do to prevent flu." Read more on the flu.
Even Low Levels of Air Pollution Tied to Low Birth Weights
Even low levels of pollution can increase the risk of low-birth weight babies, according to a new study in The Lancet Respiratory Medicine. Researchers analyzed data on more than 74,000 women in 12 European countries, finding that all types of air pollution were linked to both increased risk of low birth weights and smaller average head circumference at birth. The determined that every increase of 5 micrograms per cubic meter (mcg/m3) of fine particulate matter also increases the risk of low birth weight by 18 percent. The European Union’s current regulations call for a limit of 25 mcg/m3, but the study found the risk is still there at limits below this threshold; lowering it to the World Health Organization's guideline of 10 mcg/m3 could prevent as many as 22 percent of the cases. "Our findings suggest that a substantial proportion of cases of low birth weight at term could be prevented in Europe if urban air pollution—particularly fine particulate matter—was reduced," said lead author Marie Pedersen, MD, from the Centre for Research in Environmental Epidemiology in Barcelona, Spain. Read more on infant and maternal health.
Regular Exercise Can Boost Sperm Count, Improve Odds of Conception
Regular exercise—especially done outdoors—may boost a man’s sperm count and improve the odds of conception, according to a new study to be presented at the International Federation of Fertility Societies and the American Society for Reproductive Medicine in Boston. Researchers found that men who spent about an hour a day exercising had a 48 percent higher concentration than men who spent less than one hour a week exercising. The study also found clear associations between higher sperm counts and time spent either outdoors or lifting weights. Possible explanations include higher vitamin D levels in men who spent time outdoors in the sunshine and the increased testosterone levels and insulin sensitivity that come with lifting weights. Also, contradicting popular conceptions, the study found no link between caffeine and alcohol and decreased fertility. Read more on sexual health.
Study: Hospital CEO Salaries Tied to Patient Satisfaction, Not Quality of Care
Hospital CEO salaries tend to be higher at hospitals with high patient satisfaction ratings, and does not seem on average to be linked to either their quality of care nor the benefits they offer to their communities, according to a new study in JAMA Internal Medicine. "I was hoping I'd see even some modest relationship with quality performance," said lead researcher Ashish Jha, MD. "I think we were a little disappointed." Researchers at the Harvard School of Public Health analyzed data on 1,877 CEOs from 2,681 private, non-profit hospitals across the country, finding an average salary of $596,000; those in the lowest 10 percent earned about $118,000 and those in the highest earned about $1.7 million. While many different factors account for the wide range, Jha said the growing emphasis on improving quality measures suggests that the quality of care should be a factor when determining executive salaries. "If you're going to ask doctors and nurses to be accountable, if you're going to ask patients to be accountable…then I think we should make sure that everybody's in, and that senior managers of hospitals also have a stake in insuring high-quality care." Read more on access to health care.
Airport Noise May Increase Heart Disease and Stroke Risk
People who live near busy international airports may be at increased risk of heart disease and stroke due to the high levels of noise, according to two new studies in the British Medical Journal. One study looked at hospital admissions around London Heathrow airport, finding the risks were 10 to 20 percent higher when compared to areas with the least noise. The other study, by researchers at the Harvard School of Public Health and Boston University School of Public Health, analyzed data on more than 60 million Americans ages 65 and older living near 89 airports, finding that areas with 10 decibel higher aircraft noise also saw a 3.5 percent increase in the hospital admission rate. Researchers say the link needs further study to show causation. "The exact role that noise exposure may play in ill health is not well established," said Anna Hansell of Imperial College London, who led the British study. "However, it is plausible that it might be contributing, for example by raising blood pressure or by disturbing people's sleep." The findings indicate that populated areas must be looked at closely when communities consider expanding large airports. Read more on heart health.
Private Talk Sessions with NICU Nurses Ease Anxiety in Mothers of Premature Babies
“Listening matters” when it comes to easing the worries of the mothers of premature infants. One-on-one talks sessions between NICU nurses and the mothers can help reduce feelings of anxiety, confusion and doubt, according to a new study in the Journal of Perinatology. "Having a prematurely born baby is like a nightmare for the mother," said Lisa Segre, an assistant professor in the University of Iowa College of Nursing. "You're expecting to have a healthy baby, and suddenly you're left wondering whether he or she is going to live." The study looked at 23 mothers who when through an average of five 45-minute sessions, find they gave mothers a chance to really talk about their worries and were effective at easing concerns across the board. "Listening is what nurses have done their whole career," said NICU nurse and study co-author Rebecca Siewert. "We've always been the ones to listen and try to problem solve. So, I just think it was a wonderful offshoot of what nursing can do. We just need the time to do it." Read more on maternal and infant health.
Early Puberty Tied to Great Risk of Experimentation with Cigarettes, Alcohol and Marijuana
Early puberty is linked to increased risk of experimentation with cigarettes, alcohol and marijuana, according to a new study in the journal Addiction. Puberty typically begins between the ages of 9 and 10, will girls on average beginning it earlier than boys. "While puberty is often thought of as a solely biological process, our research has shown that pubertal development is a combination of biological, psychological and social processes that all likely interact to influence risk-taking behavior like substance use," said study author Jessica Duncan Cance, a public health researcher at the University of Texas at Austin. "Our study suggests that being the first girl in the class to need a bra, for example, prompts or exacerbates existing psychological and social aspects that can, in turn, lead to substance use and other risky behaviors early in life.” Read more on pediatrics.
Tropical Storm Karen Could Hit U.S. Gulf Coast by Weekend
CNN is reporting that a hurricane watch is in effect for parts of the U.S. Gulf Coast after a tropical storm, named Karen, formed in the southeastern portion of the Gulf of Mexico. A hurricane watch means that hurricane conditions are possible within the watch area; a watch is typically issued 48 hours before a storm is expected to hit, according to the National Hurricane Center website. Much of the National Weather Service operations are closed because of the federal shutdown, however, the National Hurricane Center website will be regularly updated, an exception to the shutdown because severe weather poses a risk to life and property. And while much of the Federal Emergency Management Agency (FEMA) is also shuttered, DisasterAssistance.gov remains fully operational, according to FEMA’s website, although “due to a lapse in federal funding, portions of some government websites linked to or from DisasterAssistance.gov may not be updated and some non-disaster assistance transactions submitted via those websites may not be processed or responded to until after funding is enacted.” Ready.gov, FEMA’s disaster preparedness website, was last updated on September 30, according to the agency, and will not be updated until after funding is enacted. A notice on the site says “information on Ready.gov may not be up to date.” Read more on disasters.
Study: Cesarean-section Delivery May Not Be Needed for Twin Births
Despite the common opinion, vaginal delivery may be just as safe as scheduled cesarean-section delivery for pregnant women with twins, according to a new study in the New England Journal of Medicine. Researchers looked at multiple subject groups, tracking the pregnancies and finding the no difference in the rate of serious adverse outcomes for either the babies or the mothers. "Studies have suggested that maybe cesarean delivery is the best way, but there's no evidence to support the swing to cesarean birth,” said lead author, Jon Barrett, MD, chief of maternal-fetal medicine at Sunnybrook Health Sciences Center in Toronto, Canada. “Perhaps the perception is that it's better for the baby.” According to the U.S. Centers for Disease Control and Prevention, as recently as 2008 about one in three single births was performed by planned cesarean section, while about three in every four twin births was via planned cesarean section. Read more on infant and maternal health.
Study: Melanoma Patients End Up Back in the Sun in 2-3 Years
While they remain appropriately cautious for the first year or so, people who were diagnosed and treated for melanoma end up going back to their old habits within two to three years, spending as much time in the sun as people who were never diagnosed with the skin cancer, according to a new study in JAMA Dermatology. People who previously had melanoma are at increased risk of developing the dangerous cancer. The American Cancer Society estimates that about 76,000 new cases of melanoma will be diagnosed this year. Brenda Cartmel, from the Yale School of Public Health, said health professionals need to rethink exactly how they’re advocating the importance of staying out of the sun. "I don't think what we are going to advise people to do is going to be different," she said. "I just think somehow we need to get that message over maybe in a different way." Read more on cancer.
Health Insurance Marketplaces Under the Affordable Care Act Open Today in Every State
Health insurance marketplaces, also known as health insurance exchanges, open today in every state under the Patient Protection and Affordable Care Act, which was signed into law three years ago. Coverage obtained through the exchanges gives purchasers guaranteed access to health care and a range of preventive services, including cancer screenings; vaccinations; care for managing chronic diseases; and mental health and substance use services. “Most importantly…coverage will translate into more opportunities to live longer, healthier and fuller lives,” saidRisa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, which has launched a comprehensive resource site to help individuals, families and small businesses learn about coverage options available to them, and enroll. Read more on the Affordable Care Act.
2010 California Pertussis Outbreak Linked to ‘Personal Belief Exemptions’ to Vaccines
Researchers have linked the 2010 California pertussis—or “whopping cough”—outbreak to parents who refused to have their children vaccinated for other than medical reasons. During the outbreak, 9,120 people became sick and 10 infants died. The study, which was published in the journal Pediatrics, looked at both outbreaks and filed personal belief exemptions, finding that people who lived in areas with high rates of such exemptions were about 2.5 times more likely to live in an area with many cases of pertussis. Approximately 95 percent of a population must be vaccinated in order for it to maintain herd immunity. Read more on vaccines.
Study: Against Medical Advice, 14 Percent of Infants Sleep in the Same Bed as Parents, Caregivers
Despite the associated risks, many infants still sleep in the same bed as parents, other adults and or children, according to a new study in the journal JAMA Pediatrics. The rate has more than doubled since the early 1990s and now stands at about 14 percent. Such sleeping arrangements increase the risk of sudden infant death syndrome (SIDS) or death from other sleep-related causes. Study co-author Marian Willinger, special assistant for SIDS at the U.S. National Institute of Child Health and Human Development, said it is important for doctors to discuss proper sleep-time habits with new parents; the study found that parents who receive advice against sleeping in the same bed as infants are 34 percent less likely to do so. Read more on maternal and infant health.
CDC: ‘Tips From Former Smokers’ Campaign Created Spikes in Quitline Calls, Website Visits
An additional 150,000 U.S. smokers called the tobacco cessation helpline 1-800-QUIT NOW as a direct result of the U.S. Centers for Disease Control and Prevention's (CDC) 2013 “Tips From Former Smokers” campaign, which ran for 16 weeks, according to CDC’s latest Morbidity and Mortality Weekly Report. That’s an increase of about 75 percent. It also generated approximately 2.8 million visits to the campaign website, or a nearly 38-fold increase. "The TIPS campaign continues to be a huge success, saving tens of thousands of lives and millions of dollars; I wish we had the resources to run it all year long," said CDC Director Tom Frieden, MD, MPH. "Most Americans who have ever smoked have already quit, and most people who still smoke want to quit. If you smoke, quitting is the single most important thing you can do for your health – and you can succeed!" A recent study in The Lancet concluded that the campaign helped as many as 100,000 people quit smoking permanently. Read more on tobacco.
FDA, NIH Award as Much as $53M for 14 Tobacco Regulation Research Centers
The U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have joined together to award as much as $53 million in funding to create 14 Tobacco Centers of Regulatory Science (TCORS). The first-of-its-kind program will bring together a diverse array of scientists, public health experts, communications veterans and marketing experts to generate research to inform the regulation of tobacco products to protect public health. “While we’ve made tremendous strides in reducing the use of tobacco products in the U.S., smoking still accounts for one in five deaths each year, which is far too many,” said NIH Director Francis S. Collins, MD, PhD. “FDA/NIH partnerships like the Tobacco Centers of Regulatory Science keep us focused on reducing the burden and devastation of preventable disease caused by tobacco use.” Read more on research.
Overweight, Underweight Pregnant Women See More Complications and Longer Hospital Stays
Pregnant women who are either too thing or too heavy as measured by body-mass index (BMI) are at increased risk for complications and additional hospitalization, according to a new study in BJOG: An International Journal of Obstetrics and Gynaecology. Women with higher BMIs saw increased complications; severely obese women were three times as likely as normal weight women to have high blood pressure and gestational diabetes, as well as longer overall hospitalizations. Lower-weight women also had higher rates of additional hospitalization (8 percent) compared to normal-weight women, though not as high as the rates for overweight and obese women. The findings indicate the need to fine and implement new approaches to combating obesity. "Longer-term benefits of reducing maternal obesity will show improvements, not only in the health outcomes of mothers and their babies, but the workload and cost to current maternity services," said study co-author Fiona Denison, MD, of Queens's Medical Research Institute in Edinburgh. Read more on maternal and infant health.
Every baby should have a chance to celebrate a healthy, happy first birthday. Unfortunately, that is not always the case. And that risk disproportionately affects people with lower income and people of color. This Infant Mortality Awareness Month, we can celebrate some progress in helping more babies reach that first milestone, according to health officials who shared successes at the Association of State and Territorial Health Officials (ASTHO) Annual Meeting in Orlando, Fla., this week.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
“We are collectively moving forward in improving birth outcomes across the nation,” said David Lakey, MD, Commissioner of the Texas Department of State Health Services and former ASTHO president, who took on healthier babies as his President’s Challenge during his tenure. Lakey set out a goal of an 8 percent reduction in premature births by 2014.
“There is a high human cost of prematurity,” said Lakey, and that cost includes low birth weight, increased morbidity and mortality, and an impact on standardized test scores and other outcomes later in life for those who do survive. “Those who are born early have a much lower chance of having a healthy, happy first birthday.”
There is also an economic and societal cost of premature birth, the cost of which is largely paid for by Medicaid. Lakey said that 57 percent of all Texas births are paid for by Medicaid. Extreme preterm birth costs an average of $71,000—while a full-term birth costs an average of $420.
Despite decades of outreach around car seat safety, car crashes remain the number one cause of death for children under the age of 12, according to the U.S. National Highway and Traffic Safety Administration (NHTSA). The numbers from the U.S. Centers for Disease Control and Prevention (CDC) are also stark and troubling: more than 1,200 U.S. children ages 14 years and younger died in motor vehicle crashes in 2010, and approximately 171,000 were injured.
What makes these statistics even more tragic is the fact that many of these deaths and injuries are preventable by following these simple edicts—put kids in the right seat and use it the right way. In fact, NHTSA has identified child seat safety restraints as the most effective way to protect young children in motor vehicle crashes.
Child safety seats reduce the risk of death in passenger cars by 71 percent for infants and by 54 percent for kids ages 1 to 4, according to the CDC. For children ages 4 to 8, booster seats cut the risk of serious injury by 45 percent.
This week is Child Passenger Safety Week. It also marks the launch of the new BuckleUpForLife.org, Cincinnati Children’s and Toyota’s community-based safety program designed to educate families on critical safety behaviors and provide child car seats to families in need.
The website features the “Making Safety a Snap” online tool—a series of quick questions and videos that demonstrate exactly how parents and caregivers can make sure their child has the right safety seat and is using it properly.
You can follow a live Buckle Up for Life Twitter Q&A starting at 2 p.m. today. Use the hashtag #BuckleUpforLife to join the discussion and have your child car seats questions answered by their experts.