Evaluating universal education and screening for postpartum depression using population-based data.

Background: In 2006, New Jersey was the first state to mandate prenatal education and screening at hospital delivery for postpartum depression. We sought to evaluate provision of prenatal education and screening at delivery, estimate the prevalence of postpartum depressive symptoms, and identify venues where additional screening and education could occur.

Methods: For women who delivered live infants during 2009 and 2010 in New Jersey, data on Edinburgh Postnatal Depression Scale scores assessed at hospital delivery and recorded on birth records were linked to survey data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based survey of mothers completed 2-8 months postpartum (n=2,391).

Maternal obesity: can pregnancy weight gain modify risk of selected adverse pregnancy outcomes?

Reports by the Institute of Medicine (IOM) recommend that gestational weight gain goals should be modified according to prepregnancy body mass index (BMI), which could result in better maternal and infant outcomes. The authors assessed whether the risk of the pregnancy outcomes such as rate of cesarean section to primiparous and multiparous women, macrosomia, and breastfeeding at 10 weeks postpartum can be modified by following the IOM guidelines for gestational weight gain irrespective of prepregnancy BMI. Staff from the New Jersey Pregnancy Risk Assessment Monitoring System interviewed a sample of women who delivered live births in New Jersey during 2002 through 2005 (n = 7661).

Surveillance of cesarean section deliveries, New Jersey, 1999-2004.

Background: Nationally and in New Jersey, the cesarean delivery rate has been increasing steadily for nearly a decade, and especially since 1999. The purpose of this study was to describe recent trends in cesarean section delivery in New Jersey.

Methods: Data on delivery method, medical indications and patient characteristics were extracted from electronic birth certificate files.

Longitudinal patterns of breastfeeding initiation.

Breastfeeding, in spite of proven benefits and energetic promotion, lags behind national goals, is less prevalent in disadvantaged populations, and declines across successive children in a family. Using longitudinally linked data from the New Jersey Electronic Birth Certificate (EBC) from 1996 to 2001, we found considerable fluidity in breastfeeding status at hospital discharge for births to the same mother. Among mothers who breastfed exclusively after the first birth, only 69% did so after the second (we refer to this as recurrence).

Comparing sociodemographic and hospital influences on breastfeeding initiation.

Background: Healthy breastfeeding practice in the United States depends decisively on high rates of initiation at the delivery hospital. We sought to estimate the component of hospital variation in rates of exclusive breastfeeding at discharge that was dependent on demographic composition. Isolating that component can help to illuminate the potential independent contribution of hospital policies, practices, and staff behaviors.

Pediatric hospitalizations for asthma: use of a linked file to separate person-level risk and readmission.

Introduction: Disparities in asthma hospitalization by gender, age, and race/ethnicity are thought to be driven by a combination of 2 factors: disease severity and inadequate health care. Hospitalization data that fail to differentiate between numbers of admissions and numbers of individuals limit the ability to derive accurate conclusions about disparities and risks.

Methods: Hospitalization records for pediatric asthma patients (aged one to 14 years) were extracted from New Jersey Hospital Discharge Files (for the years 1994 through 2000) and then linked by patient identifiers using a probabilistic matching algorithm.