Objectives: A previous study reported that increased state and local government expenditures were associated with decreased infant mortality rates (IMRs). However, reported estimates of the association between expenditures and IMR represented the degree to which the association changed each year, not the main effect. We reproduced the original results, reporting this main effect and replicated the analysis using improved methodology and updated data.
View Article and Find Full Text PDFObjective: Provide the latest national and state estimates and correlates of the proportion of young children who are healthy and ready to learn (HRTL) using a revised measure from the National Survey of Children's Health (NSCH).
Methods: Data were analyzed for 11,121 children ages 3 to 5 years from the 2022 NSCH, an address-based, parent-completed survey on the health and well-being of children in the United States. A total of 27 items across 5 domains (early learning skills, social emotional development, self-regulation, motor development, and health) were used to calculate domain-specific assessments scored as "on track," "emerging," or "needs support" according to age-appropriate developmental expectations.
This cross-sectional study examines state-level associations between severe maternal morbidity and other perinatal indicators, including prepregnancy hypertension, prepregnancy diabetes, prepregnancy obesity, low-risk cesarean delivery, preterm birth, and maternal and infant mortality.
View Article and Find Full Text PDFImportance: Surveillance of severe maternal morbidity (SMM) is critical for monitoring maternal health and evaluating clinical quality improvement efforts.
Objective: To evaluate national and state trends in SMM rates from 2012 to 2019 and potential disruptions associated with the transition to International Classification of Diseases, 10th Revision, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) in October 2015.
Design, Setting, And Participants: This repeated cross-sectional analysis examined delivery hospitalizations from 2012 through 2019 in the Healthcare Cost and Utilization Project's National Inpatient Sample and State Inpatient Databases, an all-payer compendium of hospital discharge records from community, nonrehabilitation hospitals.
Background And Objectives: The National Survey of Children's Health (NSCH) is the nation's primary source for data on children and youth with special health care needs (CYSHCN) and the only source for state-level estimates. We provide the latest estimates of CYSHCN in the United States, describe population characteristics, as well as the proportion that are served in a well-functioning system of care.
Methods: Data from the 2016, 2017, 2018, and 2019 NSCH were appended, resulting in a final analytic sample of 30 301 CYSHCN.
Background And Objectives: Hospital discharge records remain a common data source for tracking the opioid crisis among pregnant women and infants. The (ICD-10-CM) transition from the may have affected surveillance. Our aim was to evaluate this transition on rates of neonatal abstinence syndrome (NAS), maternal opioid use disorder (OUD), and opioid-related diagnoses (OUD with ICD-10-CM codes for long-term use of opioid analgesics and unspecified opioid use).
View Article and Find Full Text PDFObjective: To assess the national and state prevalence of being "Healthy and Ready to Learn" (HRL) and associated sociodemographic, health, family and neighborhood factors.
Methods: Cross-sectional analysis of the 2016 National Survey of Children's Health, a nationally representative parent-reported survey administered by web and paper June 2016 to February 2017. Four domains were constructed from 18 items through confirmatory factor analyses: "Early Learning Skills", "Social-Emotional Development", "Self-Regulation", and "Physical Well-being and Motor Development.
Importance: Substantial increases in both neonatal abstinence syndrome (NAS) and maternal opioid use disorder have been observed through 2014.
Objective: To examine national and state variation in NAS and maternal opioid-related diagnoses (MOD) rates in 2017 and to describe national and state changes since 2010 in the US, which included expanded MOD codes (opioid use disorder plus long-term and unspecified use) implemented in International Classification of Disease, 10th Revision, Clinical Modification.
Design, Setting, And Participants: Repeated cross-sectional analysis of the 2010 to 2017 Healthcare Cost and Utilization Project's National Inpatient Sample and State Inpatient Databases, an all-payer compendium of hospital discharge records from community nonrehabilitation hospitals in 47 states and the District of Columbia.
Background: Rural health disparities and access gaps may contribute to higher maternal and infant morbidity and mortality. Understanding and addressing access barriers for specialty women's health services is important in mitigating risks for adverse childbirth events. The objective of this study was to investigate rural-urban differences in health care access for women of reproductive age by examining differences in past-year provider visit rates by provider type, and quantifying the contributing factors to these findings.
View Article and Find Full Text PDFBackground: Compared to other racial/ethnic groups, infant mortality rates (IMR) are persistently highestamong Black infants in the United States, yet there is considerable regional variation. We examined state and county-level contextual factors that may explain regional differences in Black IMR and identified potential strategies for improvement.
Methods And Findings: Black infant mortality data are from the Linked Birth/Infant Death files for 2009-2011.
Introduction: Infant mortality rates are higher in nonmetropolitan areas versus large metropolitan areas. Variation by race/ethnicity and cause of death has not been assessed. Urban-rural infant mortality rate differences were quantified by race/ethnicity and cause of death.
View Article and Find Full Text PDFObjectives: To examine prevalence of safe infant sleep practices and variation by sociodemographic, behavioral, and health care characteristics, including provider advice.
Methods: Using 2016 Pregnancy Risk Assessment Monitoring System data from 29 states, we examined maternal report of 4 safe sleep practices indicating how their infant usually slept: (1) back sleep position, (2) separate approved sleep surface, (3) room-sharing without bed-sharing, and (4) no soft objects or loose bedding as well as receipt of health care provider advice corresponding to each sleep practice.
Results: Most mothers reported usually placing their infants to sleep on their backs (78.
Introduction: Reducing racial/ethnic disparities in preterm birth is a priority for U.S. public health programs.
View Article and Find Full Text PDFBackground: Meta-analyses of observational studies have shown that women with a shorter interpregnancy interval (the time from delivery to start of a subsequent pregnancy) are more likely to experience adverse pregnancy outcomes, such as preterm delivery or small for gestational age birth, than women who space their births further apart. However, the studies used to inform these estimates have methodological shortcomings.
Methods: In this commentary, we summarise the discussions of an expert workgroup describing good practices for the design, analysis, and interpretation of observational studies of interpregnancy interval and adverse perinatal health outcomes.
Background: The World Health Organization (WHO) recommends that women wait at least 24 months after a livebirth before attempting a subsequent pregnancy to reduce the risk of adverse maternal, perinatal, and infant health outcomes. However, the applicability of the WHO recommendations for women in the United States is unclear, as breast feeding, nutrition, maternal age at first birth, and total fertility rate differs substantially between the United States and the low- and middle-resource countries upon which most of the evidence is based.
Methods: To inform guideline development for birth spacing specific to women in the United States, the Office of Population Affairs (OPA) convened an expert work group meeting in Washington, DC, on 14-15 September 2017 among reproductive, perinatal, paediatric, social, and public health epidemiologists; obstetrician-gynaecologists; biostatisticians; and experts in evidence synthesis related to women's health.
Objective As part of the Title V Maternal and Child Health (MCH) Services Block Grant, administered by the Health Resources and Services Administration's (HRSA's) Maternal and Child Health Bureau (MCHB), states are required to conduct a comprehensive needs assessment identifying MCH priorities every 5 years. The most current needs assessment (2015) occurred after a transformation of the program, in which a new performance measurement framework was created. This analysis examined current patterns and trends in state MCH priorities and selected performance measures to identify changing needs and inform technical support.
View Article and Find Full Text PDFImportance: Since 2001, the American Academy of Pediatrics has recommended universal developmental screening and surveillance to promote early diagnosis and intervention and to improve the outcomes of children with developmental delays and disabilities.
Objective: To examine the current prevalence and variation of developmental screening and surveillance of children by various sociodemographic, enabling, and health characteristics.
Design, Setting, And Participants: This cross-sectional analysis of the Health Resources and Services Administration's 2016 National Survey of Children's Health-a nationally representative survey of US children completed between June 2016 and February 2017-examined 5668 randomly selected children 9 through 35 months of age whose parent or caregiver responded to the address-based survey by mail or via a website.
Objectives: To evaluate the impact of the Southern Public Health Regions' (Regions IV and IV) Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality, supported by the US Health Resources and Services Administration.
Methods: We examined pre-post change (2011-2014) for CoIIN strategies with available outcome data from vital records (early elective delivery, smoking) and the Pregnancy Risk Assessment Monitoring System (safe sleep) as well as preterm birth and infant mortality for Regions IV and VI relative to all other regions.
Results: For most outcomes, CoIIN improvements were greater in Regions IV and VI than in other regions.
Objective: Flourishing reflects positive mental health and thriving and is important for children's development and well-being. Few national studies of flourishing among school-aged children exist. Exposure to socioeconomic disadvantage is negatively associated with social and health outcomes, including flourishing.
View Article and Find Full Text PDFPurpose: To determine components of excess preterm birth (PTB) rates for U.S.-born black women relative to both foreign-born black women and U.
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