Smoking during pregnancy rates trends in a high smoking prevalence state, 1990-2009.

Objective: To assess the trends for smoking during pregnancy for whites and blacks in Missouri, a state with a high prevalence of smoking, for the period 1990-2009.

Methods: Retrospective cohort study of annual pregnancy smoking rates recorded on birth certificates. Trends were assessed by regression analyses for all births, births to whites and blacks, births to whites and blacks in aggregate, and by zip codes within the combined jurisdictions of Kansas City, St Louis City, and St Louis County.

Demographic risk factors affecting emergency room visits caused by benzodiazepine poisoning in Kansas City, Missouri, from 2001 to 2007.

Objective: The study objective was to identify demographic risk factors associated with emergency room visits caused by benzodiazepine poisoning.

Methods: A retrospective study was conducted utilizing Missouri Hospital Discharge Data for Kansas City, Missouri, USA, for 2001-2007. The data included patients' demographics such as racial group, age, sex, health insurance status and annual income.

Ponderal index of the newborn: effect of smoking on the index of the small-for-gestational-age infant.

The ponderal index (PI) is evaluated in the context of its distribution within a given population. Low PI (<10th percentile for gestational age) has been extensively studied but not much is known about the distribution and factors associated with a high (>90th percentile) PI among small-for-gestational-age (SGA) infants. This retrospective study of singleton live first births from 1990 to 2007 in a Midwestern city explores factors associated with a high PI, particularly among SGA infants.

Excess Hispanic fetal-infant mortality in a midwestern community.

Objective: We assessed excess fetal-infant mortality for Hispanic, non-Hispanic white, and non-Hispanic black populations in five contiguous counties of Missouri and Kansas.

Methods: We conducted a perinatal periods of risk (PPOR) assessment of fetal-infant mortality using electronic linked birth-death record files from 2001 through 2005. We generated an internal reference group in accordance with established PPOR protocol.

Pre-pregnancy overweight status between successive pregnancies and pregnancy outcomes.

Objective: The two objectives of this study were to (1) examine factors associated with changes in pre-pregnancy overweight to pre-pregnancy normal/underweight or obese Body Mass Index (BMI) in the subsequent pregnancy, and (2) assess select pregnancy and newborn outcomes associated with changes in pre-pregnancy BMI.

Methods: Birth certificates from 1995-2004 for residents of Kansas City, Missouri, were used to identify overweight nulliparous women who had a singleton birth and subsequently a second singleton birth. Maternal factors associated with changes in BMI between pregnancies were determined.

Risk factors for recurrent small-for-gestational-age birth.

The factors associated with recurrent small-for-gestational-age birth (R-SGA) have not been previously studied in a multiracial population. This is a retrospective cohort study of 5932 black and white women who had consecutive singleton first and second births in a Midwestern metropolis, from 1995 through 2004, to measure the risk and determine the factors associated with R-SGA. The rates for second-born small-for-gestational-age birth and R-SGA were 10.

Secular trends in excess fetal and infant mortality using perinatal periods of risk analysis.

Perinatal periods of risk (PPOR) provide an alternative analytical approach to studying infant mortality. Results can be used to focus community activities to improve infant and maternal health. This article demonstrates the use of PPOR to monitor trends in excess fetal and infant mortality related to disparities associated with race and ethnicity in Kansas City, MO (KC).

Fetal mortality: timing of racial disparities.

Whether or not racial disparities exist in fetal mortality rate (FMR) statistics depends upon the methodology used to calculate the rates. While there appears to be consensus that there is a black-white disparity in late gestation (> or = 28 weeks), the issue is unclear for early gestation (20-27 weeks). To clarify this issue, we assessed disparities in FMR for singleton fetal deaths and live births between non-Hispanic blacks and non-Hispanic whites in three counties of Missouri using gestational age- and weight-specific analyses.

Changes in smoking behavior between first and second pregnancies.

Objective: To assess changes in maternal smoking behavior at the second pregnancy.

Methods: First and second birth certificates were matched for 5241 white and black mothers in Kansas City, Mo, who had singleton births between 1994 and 2003.

Results: The pregnancy-smoking quit rate was 24.

Perinatal periods of risk analysis of infant mortality in Jackson County, Missouri.

The perinatal periods of risk (PPOR) methodology provides an easy-to-use analytical approach to infant mortality that helps focus community initiatives for improving maternal and infant health. Because few analyses have been published, many public health practitioners may be unfamiliar with PPOR. This article demonstrates the application of PPOR analysis using infant mortality in Jackson County, Missouri.

Cumulative and residual risks of small for gestational age neonates after changing pregnancy-smoking behaviors.

This retrospective cohort study examines the relationship between changing pregnancy-smoking behaviors, from the first to the second pregnancy, on second-pregnancy rates of small for gestational age (SGA) neonates. Electronic birth records provided data on 5107 pregnant women who had two singleton births in Kansas City, MO, from 1994 to 2003. Pregnancy-smoking behavior was classified by smoking status (nonsmoker [NS] or smoker [SMK]) during the first (previous)/second (current) pregnancy: NS/NS, NS/SMK, SMK/SMK, and SMK/NS.

The effect of health compromising behaviors on preterm births.

Objectives: The objective of our study was to determine whether there were combined effects of smoking, alcohol, and illicit drug use during pregnancy on the frequency of preterm births, and if so, the magnitude of the association after adjusting for confounding factors.

Methods: We conducted a retrospective cohort study of singleton live births in Kansas City, Missouri from 1990-2002. We defined health compromising behaviors as the use of cigarettes, alcohol, and illicit drugs.

Failure to embrace the barrier/condom use message.

The objective of this study was to examine the consistency of barrier/condom use among men who have sex with men in the Kansas City metropolitan area. The authors sought to determine if barrier/condom usage patterns were associated with the type of sex act and whether it was insertive or receptive, HIV testing frequency, and number of sexual partners. Data were extracted from a 2003 community health assessment of the gay, lesbian, bisexual, and transgendered community in the metropolitan area.

Emergency department visits and hospitalizations resulting from dog bites, Kansas City, MO, 1998-2002.

Dog bites are the second most costly public health problem in the United States with half of all Americans being bitten in their lifetime. Approximately 17 to 18 percent of dog bite injuries receive medical attention. Between 1998 and 2002, Kansas City, Missouri, residents made 3,467 emergency department visits for dog bite trauma and 96 individuals were hospitalized.

When bioterrorism strikes: communication issues for the local health department.

Public health preparedness is a multifaceted planning process that becomes grounded in a response plan and in effective communications, internal and external. This article describes an incident when the presence of anthrax spores was detected in a postal facility within Kansas City, Missouri, and discusses the communications issues faced by the Kansas City Health Department (KCHD). This incident provided the KCHD the first opportunity to operationalize its Incident Management System-based response plan.

Are fewer women smoking during pregnancy?

Objective: To determine whether pregnancy-smoking rates have changed in last decade.

Methods: Retrospective cohort study of 67,395 pregnancies in Kansas City over 2 epochs, 1993-1997 and 1998-2002, using computer files of birth certificates.

Results: Overall pregnancy-smoking rates decreased from 18.

Perinatal periods of risk: analysis of fetal-infant mortality rates in Kansas City, Missouri.

Objectives: The Perinatal Periods of Risk (PPOR) technique was used to analyze resident fetal and infant death data from Kansas City, Missouri, for the period 1998-2002. Results offer important information that can be used to develop community-based prevention strategies related to racial/ethnic disparities in infant mortality rates (IMR).

Methods: The PPOR approach for fetal and infant mortality can be mapped by birthweight at delivery and time of death into four strategic prevention areas: 1) Maternal Health/Prematurity (MHP), 2) Maternal Care (MC), 3) Newborn Care (NC), and 4) Infant Health (IH).

Term-gestation low birth weight and health-compromising behaviors during pregnancy.

Objective: To estimate the association between term-gestation low birth weight (term-LBW) rates and increasing numbers of health-compromising behaviors during pregnancy.

Methods: Retrospective cohort study of 78,397 term live births in Kansas City, Missouri, 1990-2002. Information on maternal and newborn characteristics was obtained form birth certificate records.

The emergence of Neisseria gonorrhoeae with decreased susceptibility to Azithromycin in Kansas City, Missouri, 1999 to 2000.

Background And Objectives: We describe the first cluster of persons with Neisseria gonorrhoeae with decreased susceptibility to azithromycin (AziDS; minimum inhibitory concentration >/=1.0 microg/mL) in the United States. GOAL The goal of this study was to identify risk factors for AziDS N.

Multijurisdictional approach to biosurveillance, Kansas City.

An electronic reporting system for a network of 22 laboratories was implemented in Kansas City, Missouri, with an independent organization acting as a data clearinghouse between the reporting laboratories and public health departments. The system ran in tandem with conventional reporting methods. Laboratory test orders and results were aggregated and mapped to a common nomenclature.