Association between Breastfeeding Duration and Type of Birth Attendant

Introduction. Healthcare providers play an integral role in breastfeeding education and subsequent practices; however, the education and support provided to patients may differ by type of provider. The current study aims to evaluate the association between type of birth attendant and breastfeeding duration. Methods. Data from the prospective longitudinal study, Infant Feeding Practices Survey II, was analyzed. Breastfeeding duration and exclusive breastfeeding duration were defined using the American Academy of Pediatrics’ national recommendations. Type of birth attendant was categorized into obstetricians, other physicians, and midwife or nurse midwife. If mothers received prenatal care from a different type of provider than the birth attendant, they were excluded from the analysis. Multinomial logistic regression was conducted to obtain crude and adjusted odds ratios and 95% confidence intervals. Results. Compared to mothers whose births were attended by an obstetrician, mothers with a family doctor or midwife were twice as likely to breastfeed at least six months. Similarly, mothers with a midwife birth attendant were three times as likely to exclusively breastfeed less than six months and six times more likely to exclusively breastfeed at least six months compared to those who had an obstetrician birth attendant. Conclusions. Findings from the current study highlight the importance of birth attendants in breastfeeding decisions. Interventions are needed to overcome barriers physicians encounter while providing breastfeeding support and education. However, this study is limited by several confounding factors that have not been controlled for as well as by the self-selection of the population

Do Successive Preterm Births Increase the Risk of Postpartum Depressive Symptoms?

Background. Postpartum depression and preterm birth (PTB) are major problems affecting women’s health. PTB has been associated with increased risk of postpartum depressive symptoms (PDS). However, it is unclear if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. This study aims to determine if PTB in women with a prior history of PTB is associated with an incremental risk of PDS. Methods. Data come from the 2009–2011 national Pregnancy Risk Assessment Monitoring System. Study sample included 55,681 multiparous women with singleton live births in the index delivery. Multiple logistic regression was used to examine the association between PTB and PDS. Results. The risk of PDS was 55% higher in women with PTB in both deliveries (aRR = 1.55; 95% CI = 1.28–1.88) and 74% higher in women with PTB in the index delivery only (aRR = 1.74; 95% CI = 1.49–2.05), compared to women with term deliveries. Conclusions. Preterm birth is a risk factor for PDS. PTB in women with a prior history of PTB is not associated with an incremental risk of PDS. Routine screening for PDS should be conducted for all women and closer monitoring should be done for high risk women with PTB

Pre-pregnancy obesity and non-adherence to multivitamin use: findings from the National Pregnancy Risk Assessment Monitoring System (2009–2011)

Background Although adequate folic acid or multivitamins can prevent up to 70 % of neural tube defects, the majority of U.S. non-pregnant women of childbearing age do not use multivitamins every day. Factors influencing consistent multivitamin use are not fully explored. This study aims to investigate the association between pre-pregnancy body mass index (BMI) and multivitamin use before pregnancy using a large, nationally representative sample of women with recent live births. Methods The national 2009–2011 Pregnancy Risk Assessment Monitoring System data were analyzed. The sample included women with recent singleton live births (N = 104,211). The outcome of interest was multivitamin use which was categorized as no multivitamin use, 1–3 times/week, 4–6 times/week, and daily use. Maternal BMI was examined as underweight (\u3c18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.00–29.99 kg/m2), and obese (≥30.00 kg/m2). Multinomial logistic regression was conducted, and adjusted odds ratios and 95 % confidence intervals were calculated. Results Compared to women with normal weight, overweight and obese women had significantly increased odds of not taking multivitamins after adjusting for confounding factors. Further, the lack of multivitamin use increased in magnitude with the level of BMI (ORoverweight = 1.2, 95 % CI = 1.1–1.3; ORobese = 1.4, 95 % CI = 1.2–1.5). Conclusions Obese and overweight women were less likely to follow the recommendation for preconception multivitamin use compared to normal weight women. All health care professionals must enhance preconception care with particular attention to overweight and obese women. Preconception counseling may be an opportunity to discuss healthy eating and benefits of daily multivitamin intake before pregnancy

Breastfeeding after Gestational Diabetes: Does Perceived Benefits Mediate the Relationship?

Introduction. Breastfeeding is recognized as one of the best ways to decrease infant mortality and morbidity. However, women with gestational diabetes mellitus (GDM) may have breastfeeding barriers due to the increased risk of neonatal and pregnancy complications. While the prevalence of GDM is increasing worldwide, it is important to understand the full implications of GDM on breastfeeding outcomes.The current study aims to investigate the (1) direct effect of GDM on breastfeeding duration and (2) indirect effect of GDM on breastfeeding duration through perceived benefits of breastfeeding. Methods. Prospective cohort data from the Infant Feeding and Practices Study II was analyzed (=4,902). Structural equation modeling estimated direct and indirect effects. Results. Perceived benefits of breastfeeding directly influenced breastfeeding duration ( = 0.392, ≤ 0.001). GDM was not directly associated with breastfeeding duration or perceived benefits of breastfeeding. Similarly, GDM did not have an indirect effect on breastfeeding duration through perceived benefits of breastfeeding. Conclusions. Perceived benefits of breastfeeding are an important factor associated with breastfeeding duration. Maternal and child health care professionals should enhance breastfeeding education efforts

Factorization and Resummation for Dijet Invariant Mass Spectra

Multijet cross sections at the LHC and Tevatron are sensitive to several distinct kinematic energy scales. When measuring the dijet invariant mass m_jj between two signal jets produced in association with other jets or weak bosons, m_jj will typically be much smaller than the total partonic center-of-mass energy Q, but larger than the individual jet masses m, such that there can be a hierarchy of scales m << m_jj << Q. This situation arises in many new-physics analyses at the LHC, where the invariant mass between jets is used to gain access to the masses of new-physics particles in a decay chain. At present, the logarithms arising from such a hierarchy of kinematic scales can only be summed at the leading-logarithmic level provided by parton-shower programs. We construct an effective field theory, SCET+, which is an extension of soft-collinear effective theory that applies to this situation of hierarchical jets. It allows for a rigorous separation of different scales in a multiscale soft function and for a systematic resummation of logarithms of both m_jj/Q and m/Q. As an explicit example, we consider the invariant mass spectrum of the two closest jets in e+e- -> 3 jets. We also give the generalization to pp -> N jets plus leptons relevant for the LHC.Comment: 37 pages, 6 figures; v2: journal versio

Racial Disparities in the Association Between Stress and Preterm Birth

Background: High levels of maternal stress have been linked to preterm births. However, findings from previous studies are inconsistent due to the varied use of stress measures. This study examined the effect of maternal stress on preterm birth, using both psychosocial and physiological measures. Methods: This study was conducted among 231 pregnant women enrolled during their first prenatal care visit. Presence of stress was assessed at enrollment using the Perceived Stress Scale (PSS) and Stressful Life Events Inventory (SLEI). Samples of maternal salivary cortisol were obtained during the first trimester and birth outcomes were ascertained at delivery. Multiple logistic regression was conducted to assess the association between stress and preterm birth. Results: The majority of the study participants were Black, not married, less educated and low income. There was an association between cortisol level and preterm birth. Per 1µg/dL increase in cortisol level, the odds of preterm birth increased by 26%. The increase was accentuated in Blacks where a unit increase in cortisol level was associated with higher odds of preterm birth (29%). Conclusions: Stress measures using PSS and SLEI did not reveal a statistically significant association with preterm birth. Health care and public health professionals should be aware of the association between increased cortisol level and preterm birth. Salivary cortisol may be a better predictor of preterm birth than PSS and SLEI

Jet p_T Resummation in Higgs Production at NNLL'+NNLO

We present predictions for Higgs production via gluon fusion with a p_T veto on jets and with the resummation of jet-veto logarithms at NNLL'+$NNLO order. These results incorporate explicit O(alphas^2) calculations of soft and beam functions, which include the dominant dependence on the jet radius R. In particular the NNLL' order accounts for the correct boundary conditions for the N3LL resummation, for which the only unknown ingredients are higher-order anomalous dimensions. We use scale variations in a factorization theorem in both rapidity and virtuality space to estimate the perturbative uncertainties, accounting for both higher fixed-order corrections as well as higher-order towers of jet-p_T logarithms. This formalism also predicts the correlations in the theory uncertainty between the exclusive 0-jet and inclusive 1-jet bins. At the values of R used experimentally, there are important corrections due to jet algorithm clustering that include logarithms of R. Although we do not sum logarithms of R, we do include an explicit contribution in our uncertainty estimate to account for higher-order jet clustering logarithms. Precision predictions for this H+0-jet cross section and its theoretical uncertainty are an integral part of Higgs analyses that employ jet binning.Comment: 24 pages, 11 figure

Source of care and variation in long acting reversible contraception use

OBJECTIVE: To examine variation in long acting reversible contraception (LARC) use by source of birth control services. DESIGN: Cross-sectional study. SETTING: Not applicable. PATIENT(S): Sexually active women who received contraceptive services in the past 12 months, who were neither pregnant nor trying to become pregnant and who were not sterilized and nor were their partners sterilized. INTERVENTION(S): Three multinomial logistic regression models assessed the relationship between source of services and LARC use, controlling for covariates. The odds of LARC use were compared with LARC nonuse, high-efficacy use, and low-efficacy use. MAIN OUTCOME MEASURE(S): Reported LARC method use. RESULT(S): There was no statistically significant difference in LARC use between women receiving services from community or public health clinics and women receiving services from private clinics. Women receiving care at a family-planning clinics had lower odds of LARC use versus LARC nonuse (odds ratio [OR] = 0.27; 95% confidence interval [CI], 0.10-0.74), versus high-efficacy method use (OR = 0.32; 95% CI, 0.11-0.88) and versus low-efficacy method use (OR = 0.13; 95% CI, 0.02-0.87) compared with those receiving services at private clinics. CONCLUSION(S): Women receiving care from family-planning clinics had lower odds of LARC use compared with those receiving care from a private doctor\u27s office or health maintenance organization facility

Optical Weak Link between Two Spatially Separate Bose-Einstein Condensates

Two spatially separate Bose-Einstein condensates were prepared in an optical double-well potential. A bidirectional coupling between the two condensates was established by two pairs of Bragg beams which continuously outcoupled atoms in opposite directions. The atomic currents induced by the optical coupling depend on the relative phase of the two condensates and on an additional controllable coupling phase. This was observed through symmetric and antisymmetric correlations between the two outcoupled atom fluxes. A Josephson optical coupling of two condensates in a ring geometry is proposed. The continuous outcoupling method was used to monitor slow relative motions of two elongated condensates and characterize the trapping potential.Comment: 4 pages, 5 figure