Establishing a pediatric prenatal visit at The Health Center (THC) in Plainfield, VT

The AAP has long recommended a prenatal visit as part of the continuum of well-child care. However, this visit is underutilized by new families. Most prenatal education focuses on labor and childbirth with little to no information about parenting and the postpartum period. The PRAMS VT Survey 2012-2014 identified “a class for new parents (parenting, not childbirth)” as a requested resource by respondents. The pediatric prenatal visit provides infant care guidance and can connect families with community organizations that provide postpartum education. The Health Center (THC) does not currently have an established pediatric prenatal visit for expecting parents.https://scholarworks.uvm.edu/fmclerk/1461/thumbnail.jp

Influenza Vaccination Coverage among Pregnant Women in Rhode Island: The Importance of the Prenatal Care Provider Role

Rhode Island's data from the Pregnancy Risk Assessment Monitoring System (PRAMS) demonstrate that health care providers play a critical role in the acceptance of influenza vaccine by pregnant women

The Effect of Cigarette Excise Taxes on Smoking Before, During and After Pregnancy

Recent analyses suggest that cigarette excise taxes lower prenatal smoking. It is unclear, however, whether the association between taxes and prenatal smoking represents a decline among women of reproductive age or a particular response by pregnant women. We address this question directly with an analysis of quit and relapse behavior during and after pregnancy. We find that the price elasticity of prenatal quitting and postpartum relapse is close to one in absolute value. We conclude that direct financial incentives to stop smoking during and after pregnancy should be considered.

An evaluation of the Sure Start Widnes Trailblazer pampering group

This project report discusses an evaluation of the pampering group of the Widnes Sure Start Widnes Trailblazer programme. The pampering group is a weekly service of health and beauty tratments to parents and parents-to-be, as well as informal advice from other parents and professionals about childbirth and child rearing in order to support parents during pregnancy and a baby's first year.The report was comissioned by Sure start Widnes Trailblazer and funded by Halton Borough Council

Factors Associated with Influenza Vaccine Uptake among Pregnant Women: Analysis of the 2015 Georgia Vital Events Information System Birth Worksheet

ABSTRACT INTRODUCTION: Influenza is a public health concern each influenza season in the United States (US). Annually, about 50,000 people die due to influenza complications in the US. Pregnant women and children under the age of five are two of the most at-risk groups for influenza-related morbidity and mortality. Since 2004, the Centers for Disease Control (CDC), the Advisory Committee on Immunization Practice (ACIP), and the American College of Obstetricians and Gynecologists (ACOG) have recommended that women who will be pregnant during the influenza season get vaccinated. Vaccination of mothers also protects infants for up to the first six months of life through the active transfer of maternal antibodies in the womb. Vaccination during pregnancy is safe and is the most effective way for mothers to protect themselves and their infants from the influenza virus. PURPOSE: Vaccination rates among pregnant women in Georgia are low, despite the CDC, ACIP, and ACOG recommendation to be vaccinated for influenza during pregnancy. In 2013, only 23.7% of women in Georgia received an influenza vaccine before or during pregnancy, a number well below the national average of 55.3% for the same year. The purpose of this study is to determine which factors are positively associated with influenza vaccine uptake during 2 pregnancy in Georgia through an analysis of the 2015 Georgia Vital Events Information System (VEIS) Birth Worksheet. The author believes that by identifying which factors show an increase in vaccine uptake, clinicians will be able to beneficially direct vaccine promotion efforts among pregnant women in Georgia. METHODS: Secondary data from the 2015 VEIS Birth Worksheet was obtained from the Georgia Department of Public Health. 130,133 women between the ages of 18 – 49 completed a Birth Worksheet in 2015 and were included in the study. Variables used for regression analysis, descriptive analysis, and prevalence of vaccine uptake include: age, race, education level, perinatal region of residence, and receipt of prenatal care. An extensive review of existing literature was also conducted. RESULTS: The prevalence of influenza vaccine uptake among pregnant women varied across the variables. 13.39% of women who completed a Birth Worksheet in 2015 reported that they received an influenza vaccine during pregnancy. The prevalence of vaccine uptake was highest among white women (65.26%), women between the ages of 25 – 34 (60.16%), women with a college degree (51.03%), and women living in the Atlanta perinatal region (44.52%). Surprisingly, of all the Atlanta region respondents, only 10.32% received an influenza vaccine despite having the largest population of all the regions in Georgia. Almost all women who received an influenza vaccine during pregnancy also received prenatal care (98.48%). Of the 115,443 women who received prenatal care, 14.87% received an influenza vaccine

Factors Associated with Influenza Vaccine Uptake among Pregnant Women: Analysis of the 2015 Georgia Vital Events Information System Birth Worksheet

ABSTRACT INTRODUCTION: Influenza is a public health concern each influenza season in the United States (US). Annually, about 50,000 people die due to influenza complications in the US. Pregnant women and children under the age of five are two of the most at-risk groups for influenza-related morbidity and mortality. Since 2004, the Centers for Disease Control (CDC), the Advisory Committee on Immunization Practice (ACIP), and the American College of Obstetricians and Gynecologists (ACOG) have recommended that women who will be pregnant during the influenza season get vaccinated. Vaccination of mothers also protects infants for up to the first six months of life through the active transfer of maternal antibodies in the womb. Vaccination during pregnancy is safe and is the most effective way for mothers to protect themselves and their infants from the influenza virus. PURPOSE: Vaccination rates among pregnant women in Georgia are low, despite the CDC, ACIP, and ACOG recommendation to be vaccinated for influenza during pregnancy. In 2013, only 23.7% of women in Georgia received an influenza vaccine before or during pregnancy, a number well below the national average of 55.3% for the same year. The purpose of this study is to determine which factors are positively associated with influenza vaccine uptake during 2 pregnancy in Georgia through an analysis of the 2015 Georgia Vital Events Information System (VEIS) Birth Worksheet. The author believes that by identifying which factors show an increase in vaccine uptake, clinicians will be able to beneficially direct vaccine promotion efforts among pregnant women in Georgia. METHODS: Secondary data from the 2015 VEIS Birth Worksheet was obtained from the Georgia Department of Public Health. 130,133 women between the ages of 18 – 49 completed a Birth Worksheet in 2015 and were included in the study. Variables used for regression analysis, descriptive analysis, and prevalence of vaccine uptake include: age, race, education level, perinatal region of residence, and receipt of prenatal care. An extensive review of existing literature was also conducted. RESULTS: The prevalence of influenza vaccine uptake among pregnant women varied across the variables. 13.39% of women who completed a Birth Worksheet in 2015 reported that they received an influenza vaccine during pregnancy. The prevalence of vaccine uptake was highest among white women (65.26%), women between the ages of 25 – 34 (60.16%), women with a college degree (51.03%), and women living in the Atlanta perinatal region (44.52%). Surprisingly, of all the Atlanta region respondents, only 10.32% received an influenza vaccine despite having the largest population of all the regions in Georgia. Almost all women who received an influenza vaccine during pregnancy also received prenatal care (98.48%). Of the 115,443 women who received prenatal care, 14.87% received an influenza vaccine

The Effects of Prenatal Education and Hospital Intervention on Breastfeeding Initiation

Breastfeeding is considered an important health practice for mothers and babies. However, Mississippi has the lowest breastfeeding rate of any state in the nation. Because of the numerous potential benefits of breastfeeding, the overall health of Mississippians could benefit from improved breastfeeding outcomes. Using 2010 data retrieved by the Pregnancy Risk Assessment Monitoring System (PRAMS) survey, which is administered through the Mississippi State Department of Health (MDH) in partnership with the Centers for Disease Control and Prevention (CDC), this study explores the factors that influence the breastfeeding decisions of mothers in Mississippi. In the PRAMS survey, women were asked whether a healthcare professional had talked to them about breastfeeding both during prenatal care visits and before discharge from the hospital. Their responses were analyzed using a logistic regression model to determine whether their decisions regarding breastfeeding initiation were influenced by the breastfeeding advice they received. Existing literature shows that women who are offered support from health professionals are more likely to breastfeed their children than those without support. This study supports this claim, showing that mothers who spoke with a healthcare worker both during prenatal visits and before discharge from the hospital were more likely to initiate breastfeeding than women who spoke with a healthcare worker just once or not at all. This knowledge can be useful in efforts to improve breastfeeding outcomes and in inspiring further research

Am J Obstet Gynecol

BACKGROUND:Contraception use among postpartum women is important to prevent unintended pregnancies and optimize birth spacing. Long-acting reversible contraception, including intrauterine devices and implants, is highly effective, yet compared to less effective methods utilization rates are low.OBJECTIVES:We sought to estimate prevalence of long-acting reversible contraception use among postpartum women and examine factors associated with long-acting reversible contraception use among those using any reversible contraception.STUDY DESIGN:We analyzed 2012\u20132015 data from the Pregnancy Risk Assessment Monitoring System, a population-based survey among women with recent live births. We included data from 37 sites that achieved the minimum overall response rate threshold for data release. We estimated the prevalence of long-acting reversible contraception use in our sample (n = 143,335). We examined maternal factors associated withlong-acting reversible contraception use among women using reversible contraception (n = 97,013) using multivariable logistic regression (long-acting reversible contraception vs other type of reversible contraception) and multinomial regression (long-acting reversible contraception vs other hormonal contraception and long-acting reversible contraception vs other nonhormonal contraception).RESULTS:The prevalence of long-acting reversible contraception use overall was 15.3%. Among postpartum women using reversible contraception, 22.5% reported long-acting reversible contraception use, which varied by site, ranging from 11.2% in New Jersey to 37.6% in Alaska. Factors associated with postpartum long-acting reversible contraception use vs use of another reversible contraceptive method included age 64 24 years (adjusted odds ratio =1.43; 95% confidence = interval 1.33\u20131.54) and 6535 years (adjusted odds ratio=0.87; 95% confidence interval =0.80\u20130.96) vs 25\u201334 years; public insurance (adjusted odds ratio = 1.15; 95% confidence interval = 1.08\u20131.24) and no insurance (adjusted odds ratio = 0.73; 95% confidence interval = 0.55\u20130.96) vs private insurance at delivery; having a recent unintended pregnancy (adjusted odds ratio = 1.44; 95% confidence interval =1.34-.54) or being unsure about the recent pregnancy (adjusted odds=ratio 1.29; 95% confidence interval =1.18\u20131.40) vs recent pregnancy intended; having 651 previous live birth (adjusted odds ratio=1.40; 95% confidence interval = 1.31\u20131.48); and having a postpartum check-up after recent live birth (adjusted odds ratio =2.70; 95% confidence interval2.35\u20133.11). Hispanic and non-Hispanic black postpartum women had a higher rate of long-acting reversible contraception use (26.6% and 23.4%, respectively) compared to non-Hispanic white women (21.5%), and there was significant race/ethnicity interaction with educational level.CONCLUSION:Nearly 1 in 6 (15.3%) postpartum women with a recent live birth and nearly 1 in 4 (22.5%) postpartum women using reversible contraception reported long-acting reversible contraception use. Our analysis suggests that factors such as age, race/ethnicity, education, insurance, parity, intendedness of recent pregnancy, and postpartum visit attendance may be associated with postpartum long-acting reversible contraception use. Ensuring all postpartum women have access to the full range of contraceptive methods, including long-acting reversible contraception, is important to prevent unintended pregnancy and optimize birth spacing. Contraceptive access may be improved by public health efforts and programs that address barriers in the postpartum period, including increasing awareness of the availability, effectiveness, and safety of long-acting reversible contraception (and other methods), as well as providing full reimbursement for contraceptive services and removal of administrative and logistical barriers.CC999999/ImCDC/Intramural CDC HHS/United States2020-07-01T00:00:00Z30885772PMC65927827915vault:3246

Am J Obstet Gynecol

OBJECTIVETo evaluate the associations between postpartum contraception and having a recent preterm birth.STUDY DESIGNPopulation-based data from the Pregnancy Risk Assessment Monitoring System in nine states were used to estimate postpartum use of highly or moderately effective contraception (sterilization, intrauterine device, implants, shots, pills, patch, and ring) and user-independent contraception (sterilization, implants, and intrauterine device) among women with recent live births (2009\u20132011). We assessed differences in contraception by gestational age ( 6427, 28\u201333, or 34\u201336 weeks versus term [ 6537 weeks]) and modeled the associations using multivariable logistic regression with weighted data.RESULTSA higher percentage of women with recent extreme preterm birth ( 6427 weeks) reported using no postpartum method (31%) compared with all other women (15%\u201316%). Women delivering extreme preterm infants had decreased odds of using highly or moderately effective methods (adjusted odds ratio [aOR]=0.5, 95% confidence interval [CI]: 0.4 \u2013 0.6) and user-independent methods (aOR=0.5, 95% CI: 0.4 \u2013 0.7) compared with women having term births. Wanting to get pregnant was more frequently reported as a reason for contraceptive non-use by women with an extreme preterm birth overall (45%) compared with all other women (15%\u201318%, p<.0001). Infant death occurred in 41% of extreme preterm births and over half (54%) of these mothers reported wanting to become pregnant as the reason for contraceptive non-use.CONCLUSIONSDuring contraceptive counseling with women who had recent preterm births, providers should address optimal pregnancy interval, and consider that women with recent extreme preterm birth, particularly those whose infants died, may not use contraception because they want to get pregnant.CC999999/Intramural CDC HHS/United States2017-04-04T00:00:00Z26003062PMC5379122665

Improving Annual Influenza Vaccination Through Patient Education

Influenza, commonly called the flu, is a seasonal respiratory virus which circulates each year and causes mild to severe illness which can lead to hospitalization and even death. Despite the advent of the flu vaccine during the Second World War, flu-related illness is the 8th leading cause of death in the United States. Each year the severity of flu in the United States is affected by many factors including characteristics of the circulating virus, timing of the season, how well the vaccine matches the season’s active strains of virus, and vaccination rates. The annual vaccination rates remain low despite public awareness of the illness and the vaccine. Therefore, educational material is a necessary step toward supplying patients with information regarding the need for, effectiveness, safety, and availability of influenza vaccines.https://scholarworks.uvm.edu/fmclerk/1168/thumbnail.jp