Racial Residential Segregation and Mental Health During Pregnancy.

Importance: Research suggests the social, physical, and socioeconomic contexts of residing in segregated neighborhoods may negatively affect mental health.

Objective: To assess the association between racial residential segregation and prenatal mental health among Asian, Black, Hispanic, and White individuals.

Design, Setting, And Participants: This population-based cross-sectional study was conducted in Kaiser Permanente Northern California (KPNC), an integrated health care delivery system.

The Causal Roadmap and Simulations to Improve the Rigor and Reproducibility of Real-data Applications.

The Causal Roadmap outlines a systematic approach to asking and answering questions of cause and effect: define the quantity of interest, evaluate needed assumptions, conduct statistical estimation, and carefully interpret results. To protect research integrity, it is essential that the algorithm for statistical estimation and inference be prespecified prior to conducting any effectiveness analyses. However, it is often unclear which algorithm will perform optimally for the real-data application.

Neighborhood Disadvantage, Race and Ethnicity, and Postpartum Depression.

Importance: Postpartum depression (PPD) is a debilitating condition with higher rates among Black individuals. Increasingly, neighborhood disadvantage is being recognized as a contributor to poor health and may be associated with adverse postpartum mental health; however, associations between neighborhood disadvantage, race and ethnicity, and PPD have not been examined.

Objective: To investigate the association between neighborhood disadvantage and PPD and evaluate the extent to which these associations may differ by race and ethnicity.

Racial and ethnic differences in perinatal depression and anxiety.

Background: Findings on racial and ethnic differences in perinatal depression/anxiety are mixed.

Methods: We assessed racial and ethnic differences in depression, anxiety, and comorbid depression/anxiety diagnoses in the year before, during, and the year after pregnancy (n = 116,449) and depression severity during (n = 72,475) and in the year after (n = 71,243) pregnancy among patients in a large, integrated healthcare delivery system.

Results: Compared to Non-Hispanic White individuals, Asian individuals had lower risk of perinatal depression and anxiety (e.

Costs of HIV prevention services provided by community-based organizations to female sex workers in Nigeria.

Background: Nigeria has been consistently targeted in sub-Saharan Africa as an HIV-priority country. Its main mode of transmission is heterosexual, and consequently, a key population of interest is female sex workers (FSWs). While HIV prevention services are increasingly implemented by community-based organizations (CBOs) in Nigeria, there is a paucity of evidence on the implementation costs of these organizations.

Associations between antidepressant use patterns during pregnancy and birth outcomes among periconception antidepressant users.

Background: Little is known about antidepressant medication use patterns during pregnancy among periconception (before and immediately following conception) users. Additionally, the associations between these patterns and birth outcomes is unclear, after taking into account underlying depression severity.

Objective: This study describes patterns of antidepressant use among periconception users and examines associations between usage patterns and birth outcomes.

Maternal and neonatal outcomes associated with treating hypertension in pregnancy at different thresholds.

Introduction: In the United States, there has been controversy over whether treatment of mild-to-moderate hypertension during pregnancy conveys more benefit than risk.

Objective: The objective of the study was to compare risks and benefits of treatment of mild-to-moderate hypertension during pregnancy.

Methods: This retrospective cohort study included 11,871 pregnant women with mild-to-moderate hypertension as defined by blood pressure (BP) values from three Kaiser Permanente regions between 2005 and 2014.

Association of serum folate levels during pregnancy and prenatal depression.

Objective: To evaluate the association between serum folate levels during pregnancy and prenatal depression and the extent to which obesity may modify this relationship.

Methods: This secondary data analysis leveraged data from a previous study of pregnant Kaiser Permanente Northern California participants who completed a survey and provided a serum sample between 2011 and 2013. Serum folate was assessed using the Center for Disease Control's Total Folate Serum/Whole Blood Microbiological Assay Method.

Racial-Ethnic Differences in Treatment Initiation for New Diagnoses of Perinatal Depression.

Objective: The adverse consequences of untreated perinatal depression highlight the need to identify populations to target in order to increase treatment rates. The authors sought to evaluate treatment initiation for a new diagnosis of depression during pregnancy or postpartum and to describe racial-ethnic differences in initiation and type (psychotherapy, antidepressants) of treatment in a large health care system with universal perinatal depression screening.

Methods: This retrospective cohort study included women who delivered a live birth in the Kaiser Permanente Northern California system between October 2012 and May 2017.

Associations of COVID-19-Related Health, Healthcare and Economic Factors With Prenatal Depression and Anxiety.

This study evaluated whether COVID-19 pandemic-related health, healthcare and economic factors during pregnancy are associated with prenatal depression and anxiety. We conducted a cross-sectional study of 6,628 pregnant members of Kaiser Permanente Northern California who responded to a survey between 22 June and 30 September 2020. The survey included questions about depression (Patient Health Questionnaire) and anxiety (Generalized Anxiety Disorder) symptoms and COVID-19-related health and healthcare (e.

Maternal and neonatal outcomes of antihypertensive treatment in pregnancy: A retrospective cohort study.

Objective: To compare maternal and infant outcomes with different antihypertensive medications in pregnancy.

Design: Retrospective cohort study.

Setting: Kaiser Permanente, a large healthcare system in the United States.

Contributions of COVID-19 Pandemic-Related Stressors to Racial and Ethnic Disparities in Mental Health During Pregnancy.

Background: This study aimed to identify racial and ethnic disparities in prenatal mental health and identify COVID-19 pandemic-related health/healthcare and economic contributors to these disparities, using an established framework for disparity investigation.

Methods: This cross-sectional study includes 10,930 pregnant people at Kaiser Permanente Northern California who completed an online survey between June 22, 2020 and April 28, 2021 on COVID-19 pandemic-related health/healthcare and economic stressors, depression, and anxiety. Self-reported race and ethnicity were extracted from electronic health records.

Lifestyle-related education and counseling resource utilization and cardiovascular biomarkers in midlife women with low physical activity.

Health plan-based resources are promising avenues for decreasing cardiovascular disease risk. This study examined associations of lifestyle-related resource utilization within a healthcare delivery system and cardiovascular biomarkers among midlife women with low physical activity. Midlife women (45-55 years old) with <10 min/week of reported physical activity at a primary care visit within a large integrated healthcare delivery system in Northern California in 2015 (n = 55,393) were identified.

Management practices in community-based HIV prevention organizations in Nigeria.

Background: Nigeria has one of the largest Human Immunodeficiency Virus (HIV) epidemics in the world. Addressing the epidemic of HIV in such a high-burden country has necessitated responses of a multidimensional nature. Historically, community-based organizations (CBOs) have played an essential role in targeting key populations (eg.

Perceived Barriers and Motivators for Physical Activity in Women With Perinatal Depression.

Background: Physical activity (PA) can help reduce depression symptom severity in women with perinatal depression. However, PA is low, and barriers and motivators for PA among women with perinatal depression are not well understood.

Methods: An ethnically diverse sample of women with perinatal depression was identified using a universal perinatal depression screening program.

Gestational weight gain and adverse pregnancy outcomes by pre-pregnancy BMI category in women with chronic hypertension: A cohort study.

Objectives: It is important to understand relationships of gestational weight gain with adverse pregnancy outcomes in women with chronic hypertension, given their high baseline risk of adverse outcomes. We assessed associations of gestational weight gain with adverse pregnancy outcomes in women with chronic hypertension by pre-pregnancy body mass index categories.

Study Design: We identified 14,369 women with chronic hypertension using electronic health records from 3 integrated health care delivery systems (2005-2014).

Prenatal Depression and Diet Quality During Pregnancy.

Background: Maternal nutrition during pregnancy has a significant effect on the health of the offspring and mother, highlighting the need for identifying factors that may affect diet during pregnancy. Research in nonpregnant and pregnant populations suggest depression may play a role.

Objective: To investigate the relationship between prenatal depression and diet quality during pregnancy overall and by race/ethnicity and to explore the relationships between prenatal depression and the 12 Healthy Eating Index 2010 dietary components.

Identifying hypertension in pregnancy using electronic medical records: The importance of blood pressure values.

Objective: To incorporate blood pressure (BP), diagnoses codes, and medication fills from electronic medical records (EMR) to identify pregnant women with hypertension.

Study Design: A retrospective cohort study of singleton pregnancies at three US integrated health delivery systems during 2005-2014.

Main Outcome Measures: Women were considered hypertensive if they had any of the following: (1) ≥2 high BPs (≥140/90 mmHg) within 30 days during pregnancy (High BP); (2) an antihypertensive medication fill in the 120 days before pregnancy and a hypertension diagnosis from 1 year prior to pregnancy through 20 weeks gestation (Treated Chronic Hypertension); or (3) a high BP, a hypertension diagnosis, and a prescription fill within 7 days during pregnancy (Rapid Treatment).

The relationship between management practices and the efficiency and quality of voluntary medical male circumcision services in four African countries.

Introduction: Given constrained funding for Human Immunodeficiency Virus (HIV) programs across Sub-Saharan Africa, delivering services efficiently is paramount. Voluntary medical male circumcision (VMMC) is a key intervention that can substantially reduce heterosexual transmission-the primary mode of transmission across the continent. There is limited research, however, on what factors may contribute to the efficient and high-quality execution of such programs.

Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe.

Background: The postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and therefore more opportunity to learn about and adopt contraceptive methods. This may be especially true for women who experience unintended pregnancy, a key target population for contraceptive programs and programs to eliminate mother-to-child HIV transmission. Among women in Zimbabwe surveyed in 2014, we examined the relationship between pregnancy intention associated with a woman's most recent pregnancy, and her subsequent postpartum contraceptive use.

Short-term effectiveness of a community health worker intervention for HIV-infected pregnant women in Tanzania to improve treatment adherence and retention in care: A cluster-randomized trial.

Introduction: Community health workers (CHWs) are lay workers who have the potential to enhance services to prevent mother-to-child HIV transmission (PMTCT) and improve the health of women living with HIV infection. We conducted a cluster-randomized trial of an intervention to integrate CHWs with 'Option B+' PMTCT services in Shinyanga Region, Tanzania.

Methods: The intervention was implemented for 11 months and included four integrated components: 1) formal linkage of CHWs to health facilities; 2) CHW-led antiretroviral therapy (ART) adherence counseling; 3) loss to follow-up tracing by CHWs; and 4) distribution of Action Birth Cards (ABCs), a birth planning tool.