Use of Practices to Reduce of Sudden Unexpected Infant Death among Caregivers of Opioid Exposed Newborns.

Objectives: Sudden unexpected infant death (SUID) occurs disproportionately among opioid exposed newborns (OENs) compared to those unexposed. The extent that primary caregivers of OENs adhere to SUID-reducing infant care practices is unknown. We examined rates of SUID-reducing practices (smoking cessation, breastfeeding, and safe sleep [supine sleep, room-sharing not bed-sharing, nonuse of soft bedding or objects]) in a pilot sample of caregivers of OENs.

Mothers Falling Asleep During Infant Feeding.

Background And Objectives: Falling asleep while feeding (FAF) infants is common. Our primary objectives were to examine (1) maternally reported prevalence of FAF and if planned; (2) association between FAF and sociodemographic factors, feeding method, and sleep location; and (3) if receipt of education about safe sleep and bedsharing risks was associated with FAF.

Methods: In the Social Media and Risk-reduction Training study, US mothers of newborns were randomized to educational messaging promoting infant safe sleep or breastfeeding.

Patterns of Prescription Medication Use during the First Trimester of Pregnancy in the United States, 1997-2018.

The objective of this analysis was to describe patterns of prescription medication use during pregnancy, including secular trends, with consideration of indication, and distributions of use within demographic subgroups. We conducted a descriptive secondary analysis using data from 9,755 women whose infants served as controls in two large United States case-control studies from 1997-2011 and 2014-2018. After excluding vitamin, herbal, mineral, vaccine, i.

Influenza vaccination during pregnancy and risk of selected major structural congenital heart defects, National Birth Defects Prevention Study 2006-2011.

Background: Although results from studies of first-trimester influenza vaccination and congenital heart defects (CHDs) have been reassuring, data are limited for specific CHDs.

Methods: We assessed associations between reported maternal influenza vaccination, 1 month before pregnancy (B1) through end of third pregnancy month (P3), and specific CHDs using data from a multisite, population-based case-control study. Analysis included 2,982 case children diagnosed with a simple CHD (no other cardiac involvement with or without extracardiac defects) and 4,937 control children without a birth defect with estimated delivery dates during 2006-2011.

Influenza vaccination during pregnancy and risk of selected major structural noncardiac birth defects, National Birth Defects Prevention Study 2006-2011.

Purpose: To assess associations between influenza vaccination during etiologically-relevant windows and selected major structural non-cardiac birth defects.

Study Design: We analyzed data from the National Birth Defects Prevention Study, a multisite, population-based case-control study, for 8233 case children diagnosed with a birth defect and 4937 control children without a birth defect with delivery dates during 2006-2011. For all analyses except for neural tube defects (NTDs), we classified mothers who reported influenza vaccination 1 month before through the third pregnancy month as exposed; the exposure window for NTDs was 1 month before through the first pregnancy month.

The Impact of Maternal Worry on Infant Care Practices.

Objectives: Examine the 1) prevalence of worries among US mothers of infants; 2) association between worries and American Academy of Pediatrics recommended infant care practices (breastfeeding, supine sleep, roomsharing without bedsharing); 3) association of maternal and household characteristics with worries.

Methods: We analyzed a nationally representative sample of 3165 mothers who were surveyed regarding safe sleep and breastfeeding when infants were 2 to 6 months of age in 2011-2014. We examined the prevalence of 8 maternal worries (housing, job, income, neighborhood, family relationships, health, baby's health, family member health).

The Impact of Breastfeeding and Safe Sleep Mobile Health Messaging on Breastfeeding and Bedsharing.

Objective: Mobile health (mHealth) safe sleep messaging increases rates of safe sleep. Bedsharing is more common among breastfeeders. Advice to not bedshare may negatively impact breastfeeding.

Variation in United States COVID-19 newborn care practices: results of an online physician survey.

Background: Newborn care practices that best promote the health and well-being of mother-infant dyads after birth while minimizing transmission of COVID-19 were uncertain at the onset of the COVID-19 pandemic.

Objective: Examine variation in COVID-19 newborn care practices among U.S.

Disparities in Breastfeeding Among U.S. Black Mothers: Identification of Mechanisms.

Disparities in U.S. breastfeeding rates persist among Black mothers according to birth country and between Black and White mothers, necessitating further investigation of modifiable mediating factors to inform interventions.

National Prevalence of Donor Milk Use Among Level 1 Nurseries.

Background And Objectives: Donor milk use has increased among very preterm infants because of mounting evidence of health benefits; however, the extent that donor milk is used among healthy term infants in level 1 nurseries is unclear. We aimed to determine (1) national prevalence of and (2) hospital factors associated with donor milk use in level 1 nurseries.

Methods: Among 3040 US birthing hospitals, we randomly selected hospitals from each of 4 US regions (119 in northeast, 120 in Midwest, 116 in west, and 103 in south) for a total of 458 hospitals.

Folic acid antagonist use before and during pregnancy and risk for selected birth defects.

Background: Maternal folic acid (FA) intake before and during early pregnancy reduces the risk for neural tube defects (NTDs); evidence suggests it may also reduce the risk for oral clefts, urinary defects, and cardiac defects. We sought to re-examine the use of drugs, which affect folate metabolism, dihydrofolate reductase inhibiting (DHFRI) medications, and anti-epileptic drugs (AEDs), in data collected in the post-FA fortification era (1998+) in the Slone Birth Defects Study.

Methods: We assessed maternal DHFRI and AED use and risk for NTDs, oral clefts, and urinary and cardiac defects.

Factors Associated With Choice of Infant Sleep Location.

Objective: To assess the prevalence of and factors associated with actual recent practice and near-future intention for infant sleep location in a national sample.

Methods: There were 3260 mothers from 32 US hospitals who responded to a survey at infant age 2 to 6 months regarding care practices, including usual and all infant sleep locations in the previous 2 weeks and intended location for the next 2 weeks. Mothers were categorized as (1) having practiced and/or intending to practice exclusive room-sharing without bed-sharing, (2) having practiced anything other than exclusive room-sharing but intending to practice exclusive room-sharing, (3) intending to have the infant sleep in another room; and (4) intending to practice bed-sharing all night or part of the night.

Tetanus, diphtheria, and pertussis vaccine (Tdap) in pregnancy and risk of major birth defects in the offspring.

Background: The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended during pregnancy to protect newborns against pertussis infection in the months prior to their primary pertussis vaccination. Although research on the safety of the vaccine has been reassuring, most previous studies have considered major malformations as a single outcome, and have not examined potential risks for specific malformations.

Methods: Using data from the Slone Epidemiology Center Birth Defects Study collected between 2006 and 2015, we identified exposures to Tdap vaccine in both early and late pregnancy and examined potential risks for specific malformations.

Oseltamivir exposure in pregnancy and the risk of specific birth defects.

Background: Influenza during pregnancy contributes to maternal morbidity and mortality. Neuraminidase inhibitors, including oseltamivir, are recommended for treating women with influenza during pregnancy.

Methods: Data from the Slone Birth Defects Study from 2009 to 2015 were used to investigate associations between oseltamivir and specific birth defects.

Risk factors for congenital microcephaly in the pre-Zika era.

Background: The Zika epidemic has brought increased attention to congenital microcephaly as a birth outcome. However, little is known about risks for microcephaly unrelated to Zika.

Methods: Using data from the Slone Epidemiology Center Birth Defects Study from 1993 to 2015, we identified 57 cases of microcephaly alone ("isolated") and 109 cases of microcephaly that included other major birth defects ("non-isolated"), and considered a large number of potential risk factors including demographic characteristics, illnesses, and medications used during pregnancy.

Periconceptional maternal fever, folic acid intake, and the risk for neural tube defects.

Purpose: Previous studies have shown an association between maternal fever in early pregnancy and neural tube defects (NTDs) such as spina bifida. Periconceptional folic acid intake has been shown to reduce the risk of these outcomes.

Methods: Using data from the Slone Epidemiology Center Birth Defects Study (1998-2015), we examined the impact of folic acid on the relationship between maternal fever in the periconceptional period (28 days before and after the last menstrual period) and NTDs.

The Effect of Nursing Quality Improvement and Mobile Health Interventions on Infant Sleep Practices: A Randomized Clinical Trial.

Importance: Inadequate adherence to recommendations known to reduce the risk of sudden unexpected infant death has contributed to a slowing in the decline of these deaths.

Objective: To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions.

Design, Setting, And Participants: Four-group cluster randomized clinical trial of mothers of healthy term newborns who were recruited between March 2015 and May 2016 at 16 US hospitals with more than 100 births annually.

Variation in Safe Sleep and Breastfeeding Practices Among Non-Hispanic Black Mothers in the United States According to Birth Country.

Objective: To examine variation in safe sleep and breastfeeding practices among US non-Hispanic black (NHB) mothers according to birth country.

Methods: We analyzed NHB mothers who were surveyed regarding safe sleep and breastfeeding practices when their infants were 2 to 6 months of age in 2011 to 2014, as part of a larger national study. We examined prevalences of safe sleep and breastfeeding practices according to birth country and examined odds of adherence to American Academy of Pediatrics recommended safe sleep and breastfeeding practices in foreign-born NHB mothers, compared with US-born NHB mothers.

Comparison of Text Messages Versus E-mail When Communicating and Querying With Mothers About Safe Infant Sleep.

Objective: To assess how mothers' choice of e-mail or text messages (SMS) to receive safe sleep communications is associated with educational video viewing and responses to care practice queries.

Methods: Seven hundred ninety-two new mothers received safe sleep-related communications for 60 days after newborn hospital discharge as part of a trial of health education interventions on infant care practices. Mothers chose e-mail or SMS for study communications and were sent 22 short safe sleep videos and 41 queries regarding infant care practices.

Predictors of Maternal Trust in Doctors About Advice on Infant Care Practices: The SAFE Study.

Objective: To determine predictors of maternal trust in doctors about advice on infant care practices.

Methods: Using probability sampling methods, we recruited mothers from 32 US maternity hospitals. Mothers completed a survey 2 to 6 months postpartum that included questions about maternal trust in doctors regarding 6 infant care practices and physician characteristics (doctor asked mother's opinion, doctor is qualified, infant sees 1 main doctor who is/is not of the same ethnicity/race).