Qualitative Analysis of the Lived Experience of Reproductive and Pediatric Health Care in the Military Health Care System.

Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System.

Physician Workforce Diversity Is Still Necessary and Achievable if It Is Intentionally Prioritized.

The 2023 Supreme Court Decision from Students for Fair Admissions v. Harvard and Students for Fair Admissions v. University of North Carolina threatens the current progress in achieving diversity within undergraduate and graduate medical education.

Maternal and Neonatal Outcomes of Adolescent Pregnancies in the Military Health System.

Objective: To determine if universal access to care for military beneficiaries improves timing of presentation to prenatal care (PNC) in adolescent and young adult (AYA) pregnancies, improving maternal and neonatal outcomes.

Study Design: Retrospective descriptive cohort study, which assessed PNC initiation in eligible military beneficiaries: dependent daughters, active-duty women, and active-duty spouses aged 13 to 26 between January 2015 and December 2019, and subsequent adverse maternal and neonatal outcomes.

Results: The cohort included 4,557 eligible pregnancies and 4,044 mothers aged 13 to 26.

Readmission Reduction for Hyperbilirubinemia in Infants ≥ 35 Weeks Estimated Gestational Age Using a Standardized Protocol.

Background: Most newborns experience hyperbilirubinemia. Monitoring and treatment must be balanced with the risk of unintended harm, including readmission to the birth hospital. From January 2019 to April 2021, the average rate of inborn readmission for all causes was 2.

Newborn medication adherence and childhood under-immunization in military beneficiaries.

Background: The American Academy of Pediatrics recommends birth doses of vitamin K, erythromycin ointment, and the hepatitis B vaccine, but the relationship between birth medication administration and childhood immunization compliance is understudied. The objective of this study is to evaluate rates of newborn medication administration, and risk factors for refusal in military beneficiaries and determine the relationship between medication refusal and under-immunization at 15 months.

Methods: A retrospective chart review was completed for all term and late preterm infants born at Brooke Army Medical Center, San Antonio, TX, from January 1, 2016, to December 31, 2019.

The association of regional perinatal risk factors and neonatal intensive care capacity for Military Health System-insured newborns.

Objective: To characterize hospitals where military-insured newborns received care and test the association of regional perinatal risk with neonatal intensive care unit (NICU) capacity.

Study Design: We identified birth hospitals for live newborns October 2015-December 2018 (n = 296,568) and assigned newborns to health service areas (HSAs). Perinatal risk factors and the number of neonatal special care beds and neonatologists were calculated at HSA levels.

Neonatal mortality and disparities within the military health system.

Introduction: Racial disparity exists in U.S. neonatal mortality; Black, non-Hispanic neonates are at higher risk of death.

Longitudinal growth changes from birth to 8-9 years in preterm and full term births.

Background: The aim of this study is to assess the effect of age at adiposity rebound (AR) and changes in growth between birth and 6 months on growth status at 8-9 years in children born term and preterm. Age at AR is inversely correlated with risk for later obesity in children born full term, but has not been analyzed in children born preterm.

Methods: Birth anthropometrics, and weight and length/height data from age 6 months through 8-9 years were recorded for 175 children born in 2008 in the military health system.

Self-resolving superficial primary cutaneous mucormycosis in a 7-week-old infant.

A 7-week-old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self-resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation.

Local Trends in the Evaluation and Treatment of Urinary Tract Infections and Vesicoureteral Reflux in Children.

Introduction: The management of urinary tract infection in children has changed in the last decade due to worries about antibiotic overuse, and the trauma and radiation of voiding cystourethrograms. We examined whether there has been a change in the management of pediatric urinary tract infection in our practice.

Methods: We reviewed billing records from 2005 to 2013 to determine the number of voiding cystourethrograms performed as well as the number of operations (open and endoscopic) for vesicoureteral reflux.